涎腺淋巴上皮癌5例临床病理分析

摘要

目的:探讨涎腺淋巴上皮癌的临床病理学特征.方法:对5例涎腺淋巴上皮癌的临床特征、组织学形态和免疫组织化学表型进行观察,并对相关文献进行复习.结果:4例肿瘤发生在腮腺,1例发生于左颌下腺.其中1例继发于良性淋巴上皮病变.临床主要表现为局部包块,活动度差,伴有疼痛.组织学特点:涎腺组织中淋巴组织及纤维组织增生,淋巴样间质中见上皮样肿瘤细胞团呈片状、岛状、条索状和巢状浸润,淋巴细胞呈多少不一浸润肿瘤组织,肿瘤细胞核呈泡状,可见淋巴滤泡形成.免疫组化检测,瘤细胞AE1/AE3(+),EMA(+),p63(+),CK5/6(+),S-100(-),SMA(-),Vimentin(-),LCA(-),肿瘤间质淋巴细胞表达CD3(+)或CD20(+);原位杂交检测,瘤细胞EBER(+).结论:涎腺的淋巴上皮癌作为独立的肿瘤实体,有其特征,免疫表型呈AE1/AE3(+),EMA(+),p63(+),CK5/6(+),需与良性淋巴上皮病变等鉴别.%Objective:To investigate the clinicopathological features of the salivary gland lymphoid epithelial carcinoma.Methods:The clinical features,histological and immunohistochemical phenotypes of 5 cases of salivary gland carcinoma were observed,and the related literature was reviewed.Results:Four cases occurred in the parotid gland,one case occurred in the left submandibular gland,including one case of secondary to benign lymphoepithelial lesion.The main clinical manifestations were local mass,activity and pain.Histological features:salivary gland tissue in lymphatic tissue and fibrous tissue.hyperplasia,lymphoid matter clusters of epithelioid tumor cells were flaky,island,cords and nests,lymphocyte infiltrated tumor tissue with different frequences.The tumor nuclei were vesicular chromatin empty and visible reactivity lymphoid follicles.Immunohistochemical expression:All cases of tumor cells were positive for AE1/AE3,EMA,p63,CK5/6,while other markers including S-100,SMA,Vimentin,LCA were negative.Tumor stroma cells were positive for CD3,CD20,in situ hybridization:tumor cells were positive for EBER.Conclusion:Lymphoepithelial carcinoma of salivary glands as independent tumor entity,has its characteristics,the immune phenotype was positive for CK(+),EMA(+),p63(+),CK5/6(+),need to identify with benign lymphoepithelial lesions.