腮腺高分化黏液表皮样癌10例的临床病理特征及诊断探讨

Clinicopathological features and diagnosis of 10 cases of well-differentiated mucoepidermoid carcinoma of parotid

目的 :提高腮腺高分化黏液表皮样癌 (MEC)诊断准确率。方法 :回顾分析本院口腔科 1987年 1月～ 2 0 0 3年 1月收治的10例腮腺高分化MEC的病理特征和诊断资料。结果 :10例中有 2例误诊为淋巴结肿大 ,4例误诊为多形性腺瘤。本组行细针吸取细胞学检查 2例中 ,1例提示MEC ,经术中所示和术后标本证实 ;另 1例由于抽取细胞数量少、诊断者临床经验不足 ,提示为良性病变 ,行冷冻切片证实为高分化MEC。肿瘤有不规则的浸润性边界 ,由充满黏液的囊腔和不规则的肿瘤巢构成 ,肿瘤细胞呈良性型核 ,核分裂像罕见。结论 :腮腺高分化MEC常被误诊为多形性腺瘤 ,术前行细针吸取细胞病理学检查有助于高分化MEC的诊断。

Objective To summarize clinicopathological features of well-differentiated mucoepidermoid carcinoma of parotid to raise diagnostic accuracy.Method The clinical data and pathological features of 10 cases from January 1987 to January 2003 were reviewd.Results Among the 10 cases,2 cases were misdiagnosed as lymph node swelling,and 4 cases were misdiagnosed as plemorphic adenoma.2 others underwent fine needle aspiration,one of which was suggestive of MEC and later confirmed by intra-operative observation and postoperative examination;the other of which,due to limited amount of aspirated cells and the operator's inexperience,suggested benign pathological process,but later confirmed well-differentiated MEC by freezing microtomy.The tumor exhibited irregular invasive borders,and comprised mucin-filled cysts and irregular tumor nests.The tumor cells had bland nuclei,and mitotic figures were rare.Conclusions The tumor is very likely to be misdiagnosed as pleomophic adenoma.Preoperative fine needle aspiration is helpful for early diagonosis of well-differentiated mucoepidermoid carcinoma.