具有沃氏样特征的黏液表皮样癌--罕见病例报告

Shital Samir Joshi, S. Kadam
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摘要

具有Warthin样特征的黏液表皮样癌是一种具有欺骗性的肿瘤,有可能被误诊为良性Warthin瘤、黏液和鳞状化生的Warthin瘤或由Warthin瘤转化而来的MEC。我们要介绍的是一例 25 岁女性左侧腮腺复发性单发肿块病例。显微镜下,肿块主要由囊性区域和局灶实性浸润性肿瘤组成,肿瘤内有黏液细胞、中间细胞和表皮细胞,在纤维化基质中结构复杂。可见细胞外粘蛋白池。囊性区域内衬为单层和双层上皮细胞,基质为淋巴细胞(Warthin 样形态)。偶见有丝分裂。未见坏死和神经周围侵犯。免疫组化结果显示,肿瘤的 P63、P40、CK5/6、EMA 和 Mucicarmine 染色阳性,CK7 弥漫阳性。我们得出的最终结论是低级别 MEC,具有类似 Warthin 的特征。尽管细胞遗传学研究是确证性的,但我们强调组织形态学研究与 IHC 和临床病史在鉴别这种具有 Warthin 样特征的 MEC 罕见变异中的作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Mucoepidermoid carcinoma with Warthin like features- rare case report
Mucoepidermoid carcinoma with Warthin like features is a deceptive tumour and can be potentially misdiagnosed as a Warthin tumour which is benign, Warthin tumour with mucinous and squamous metaplasia or MEC transformed from Warthin tumour. We are presenting a case of a 25-year-old woman with recurrent solitary mass in the left parotid gland. Microscopically it consists of predominantly cystic areas and focal solid infiltrative tumour with mucinous, intermediate and epidermoid cells having complex architecture in a fibrotic stroma. Extracellular mucin pools seen. Cystic areas are lined by monolayered as well as bilayer epithelium with lymphoid stroma (Warthin like morphology). Occasional mitosis noted. No necrosis and perineural invasion seen. Immunohistochemically, the tumour is positive for P63, P40, CK5/6, EMA, Mucicarmine stain, diffusely positive for CK7. We reached at the final conclusion of low grade MEC, Warthin like features. Even though the cytogenetic studies are confirmatory, we emphasize the role of histomorphology study with IHC and clinical history in identifying this rare variant of MEC with Warthin like features.
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