气管上皮-肌上皮癌的临床病理学观察

摘要

Purpose To investigate the clinicopathological characteristics and differential diagnosis of epithelial-myoepithelial carcinoma ( EMC ) of the bronchial. Methods To studied a case of EMC of the bronchial by light microscopy, histochemistry, and immuno-histochemistry, and reviewed relevant literature to analyze the clinical, morphological and immunohistochemical features, treatment and prognosis of the EMC. Results The patient was a 25 years old man. The EMC is characterized histologically by a lobulated growth pattern, with mixed tubular and solid areas. The tumor demonstrated a double-layering glandular structures consisted of epithelial and myoepithelial cells. The inner layer was lined by adenoid cells and outer layer by myoepithelial cells. Immunohistochemical stainng showed that the adenoid cells were positive for CK and EMA, and myoepithelial cells were positive for SMA, p63 , HHF35, GFAP, vi-mentin and S-100 protein. Conclusions The primary EMC in the bronchial is a very rare tumor with imaging features. The diagnosis is based on immunohistochemical staining. It should be differentiated from other lesions of the bronchial, including plemorphic adenoma, oncocytoma, adenoid cystic carcinoma and mucoepidermoid carcinoma. For the treatment of the EMC, surgical resection combined with other therapies has a good prognosis.%目的 观察气管上皮-肌上皮癌(epithelial-myoepithelial carcinoma,EMC)的临床病理学、影像学特点,探讨其免疫组化特征及鉴别诊断.方法 采用组织学、免疫组化及组织化学技术对1例气管EMC进行光镜观察及免疫标记,并结合相关文献对其临床表现、影像学、组织形态和免疫组化特点等进行综合分析.结果 患者男性,25岁,肿瘤病理组织学表现为分叶状生长,管状和实性区混合存在.瘤细胞由上皮和肌上皮细胞组成,呈双层腺管样结构.免疫组化染色示:上皮细胞CK、EMA均(+),肌上皮细胞SMA、S-100、p63、HHF35、GFAP均(+),管状结构周围PAS染色(+).结论 原发于气管的EMC十分罕见,影像学具有一定特征,免疫组化染色有助于该肿瘤的诊断,应与多形性腺瘤、肌上皮瘤、嗜酸细胞瘤、腺样囊性癌等鉴别;以手术切除为主的综合治疗预后较好.