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观察18例粘液表皮样癌(12例发生于腮腺,6例发生于小涎腺)的病理学改变。按实体性上皮团与粘液腺管的比例瘤组织可分三种类型:1. 粘液腺管为主型(4例);2. 实体性上皮团为主型(4例);3. 粘液腺管与实体性上皮团混合型(7例);4. 特殊型(3例)。透射电镜观察2例的中间型细胞,胞浆中或有分泌物前体,或有成熟的分泌颗粒;有的细胞内有多量张力细丝;细胞间或见桥粒,或有发育不良的细胞连接。以上发现表明中间型细胞是一种具有向棘细胞和腺细胞双向分化能力的低分化瘤细胞。在4例中观察到较大导管上皮由单纯增生、异常增生过渡到癌的形态学表现,一例见癌旁导管上皮异型增生。这5例癌的组织学类型3例为实体上皮团为主型,2例为实体性上皮团与粘液腺管混合型。
Eighteen cases of mucoepidermoid carcinoma (12 in the parotid gland and 6 in the lesser salivary gland) were observed for pathological changes. According to the ratio of substantive epithelial mass and mucinous duct tumor tissue can be divided into three types: 1. Mucous duct type (4 cases); 2. Solid epithelial mass-based (4 cases); 3. Mucous gland Tubular and substantive epithelial mixed group (7 cases); 4 special type (3 cases). Transmission electron microscopy observed in 2 cases of intermediate cells, or in the cytoplasm secretions have secretions, or mature secretory granules; some cells have a lot of tension filaments; intercellular or desmosomes, or dysplastic cell connections . The above findings indicate that the intermediate type cells are poorly differentiated tumor cells that have the ability to bidirectionally differentiate into spinous cells and glandular cells. In 4 cases, a larger ductal epithelium was observed, which showed the transition from simple hyperplasia and dysplasia to the morphological manifestations of cancer. In one case, the adjacent ductal epithelial dysplasia was observed. The histological types of the 5 cases were mainly of solid epithelium and 2 of them were mixed epithelium with mucous duct.