诊断缺陷:原发性泪腺肌上皮癌,病例报告及文献复习。

Q2 Medicine
BMC Clinical Pathology Pub Date : 2018-08-02 eCollection Date: 2018-01-01 DOI:10.1186/s12907-018-0073-4
Youssef Mahdi, Mohamed Amine Azami, Rajae Daoudi, Nadia Cherradi
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引用次数: 6

摘要

背景:泪腺以淋巴瘤和炎性病变为主。原发性上皮肿瘤占不到30%的泪腺病变。泪腺肌上皮癌是罕见的。据我们所知,文献中只报道了9例。这种病变呈现诊断困难:非特异性临床和放射学表现和组织学多态性。这很好地说明了在文献中描述的诊断病理错误。我们报告一例新的泪腺肌上皮癌,并回顾其他已发表的病例,试图评估这种罕见肿瘤的临床病理特征和预后。病例介绍:一名80岁阿拉伯女性,右眉肿胀、疼痛、右眼突出和复视2个月。计算机断层扫描显示一模糊、均匀、增强对比度的肿块附着于内侧直肌。进行了活检。镜下检查为恶性梭形细胞瘤,与肉瘤或肉瘤样癌最一致。由于肿瘤材料已经耗尽,免疫组化研究无法进行。随后,行右眼眶全切除术。免疫组化结果显示,全细胞角蛋白AE1/AE3、上皮膜抗原(EMA)、平滑肌肌动蛋白(SMA)弥漫性阳性,S100蛋白局灶性阳性。病变对desmin、h-cladesmon、CD34、Melan-A和HMB-45均呈免疫阴性。肿瘤已扩散到手术边缘。患者在切除手术3个月后出现局部肿瘤进展,才开始随访。患者再次失去随访,因此未在我院接受任何其他治疗。结论:我们报告了一个罕见的肿瘤,其位置不寻常。使用上皮和肌上皮标志物阳性的完整免疫组织化学小组帮助我们对这种低分化肿瘤进行分类。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Diagnostic pitfall: primary myoepithelial carcinoma of the lacrimal gland, case report and literature review.

Diagnostic pitfall: primary myoepithelial carcinoma of the lacrimal gland, case report and literature review.

Diagnostic pitfall: primary myoepithelial carcinoma of the lacrimal gland, case report and literature review.

Diagnostic pitfall: primary myoepithelial carcinoma of the lacrimal gland, case report and literature review.

Background: In lacrimal gland, lymphomas and inflammatory lesions predominate. Primary epithelial tumours represent less than 30% of lacrimal gland lesions. Myoepithelial carcinoma of lacrimal gland is rare. To the best of our knowledge, only nine cases have been reported in the literature. This lesion presents diagnostic difficulties: non-specific clinical and radiological findings and histological polymorphism. This is well illustrated by the diagnostic pathology errors described in the literature.We report a new case of lacrimal myoepithelial carcinoma with a review of others published cases to try to assess clinico-pathological features and outcome whenever possible of this rare tumour.

Case presentation: An 80-year-old Arabian female presented with a 2-month history of swelling over the right eyebrow, pain, proptosis of the right eye and diplopia. Computed tomography demonstrated an ill-defined, homogeneous, contrast-enhancing mass attached to the medial rectus. A biopsy was performed. Microscopic examination showed malignant spindle cells tumour, most consistently to sarcoma or sarcomatoid carcinoma. Immunohistochemical study was not possible because neoplastic material has been exhausted. Subsequently, total exenteration of the right orbit was performed. Immunohistochemical study revealed diffuse positive staining for pancytokeratin AE1/AE3, epithelial membrane antigen (EMA) and smooth muscle actin (SMA) and focal positivity for S100 protein. The lesion was immunonegative for desmin, h-cladesmon, CD34, Melan-A and HMB-45. The tumour was extending to the surgical margins. The patient was lost to follow-up until she developed local tumour progression 3 months after removal. The patient was again lost to follow-up and therefore did not receive any other treatment in our hospital.

Conclusion: We present this rare tumour with an unusual location. The use of a complete immunohistochemical panel with epithelial and myoepithelial markers positivity helped us for classification of this poorly differentiated tumour.

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来源期刊
BMC Clinical Pathology
BMC Clinical Pathology Medicine-Pathology and Forensic Medicine
CiteScore
3.30
自引率
0.00%
发文量
0
期刊介绍: BMC Clinical Pathology is an open access journal publishing original peer-reviewed research articles in all aspects of histopathology, haematology, clinical biochemistry, and medical microbiology (including virology, parasitology, and infection control). BMC Clinical Pathology (ISSN 1472-6890) is indexed/tracked/covered by PubMed, CAS, EMBASE, Scopus and Google Scholar.
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