筛状结构为主的涎腺基底细胞腺瘤临床病理特征及免疫表型

摘要

Purpose To study the clinicopathologic features and immunophenotype of the basal cell adenoma ( BCA) with a focal crib-riform pattern in salivary gland. Methods Four cases of BCA with a focal cribriform pattern were retrospectively analyzed with their clinical findings, histopathology and immunohistochemical staining for CK, CK14, CK8/18, CK19, EMA, CD10, CD117, BCL-2, CDX-2, SMA, S-100, p63, p53, EGFR and Ki-67. Results Four cases of BCA with a focal cribriform structure all appeared as slow-growing neoplasms with good circumscription and lack of infiltrative properties, with capsular invasion but without capsular break-through. There are have at least a 50% area of cribriform structure in tumors under microscope. Immunohistochemical profiles exhibi-ted weak positivity for CK, EMA, CD10, CD117, BCL-2, CDX-2, p53 and EGFR, moderate for CK14, CK8/18, SMA and S-100, and strong for CK19, p63 and Ki-67 index<1%. Conclusions Cribriform type of salivary bacal cell adenoma is relatively rare and has difficulty in distinction from adenoid cystic carcinoma ( ACC) . Clinicopathologic features and immunophenotype are the most relia-ble points for differential diagnosis of BCA from ACC.%目的：探讨以筛状结构为主的涎腺基底细胞腺瘤( basal cell adenoma, BCA)的临床病理学及免疫表型特征。方法回顾性分析4例以筛状结构为主的涎腺BCA临床病史和病理学特征,采用免疫组化法检测 CK、CK14、CK8/18、CK19、EMA、CD10、CD117、BCL-2、CDX-2、SMA、S-100、p63、p53、EGFR、Ki-67的表达。结果4例以筛状结构为主的BCA均生长缓慢,分界清楚,无周围组织浸润,有被膜内浸润但未突破被膜,镜下见瘤组织中筛状结构占50%以上。免疫表型：肿瘤细胞中 CK、EMA、CD10、CD117、BCL-2、CDX-2、p53、EGFR均呈(+),CK14、CK8/18、SMA、S-100均呈(〹),CK19和p63呈(〹)；Ki-67增殖指数<1%。结论以筛状结构为主的BCA较罕见,与腺样囊性癌( adenoid cystic carcinoma, ACC)不易区分,结合临床病理及免疫表型特征等可进行鉴别。