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目的 探讨涎腺多结节形态原发恶性肌上皮瘤的病理特征。方法 光镜观察19例涎腺多结节形态原发恶性肌上皮瘤的组织学、细胞学结构,其中11例做Calponin、平滑肌肌动蛋白(SMA)、S-100、神经胶质酸性蛋白(GFAP)、细胞角蛋白、增殖细胞核抗原(PCNA)的免疫组化检测,3例做超微结构观察。结果 肿瘤上皮巢呈多结节生长,中央常伴坏死,肿瘤侵袭周围组织,细胞有异形,肿瘤细胞主要为上皮样细胞型,有较多肿瘤性基质形成。肌上皮性标记及部分细胞角蛋白、PCNA标记阳性。电镜下见肿瘤细胞内有肌微丝。结论 免疫组化染色及超微结构观察均支持肿瘤为肌上皮来源及恶性特征。
Objective To investigate the pathological features of salivary gland multi-nodular primary malignant myoepithelioma. Methods Twenty-nine cases of salivary gland multi-nodular primary malignant myoepithelioma were observed under light microscope. Of them, 11 cases had Calponin, SMA, S-100 and glial acidic protein GFAP), cytokeratin, and proliferating cell nuclear antigen (PCNA) were detected by immunohistochemistry. Three cases were observed by ultrastructure. Results The tumor epithelium showed multiple nodules and often accompanied with necrosis in the center. The tumor invaded the surrounding tissue and the cells were abnormal. The tumor cells were mainly epithelioid cell type with more tumorous matrix formation. Myoepithelial markers and some cytokeratin, PCNA markers were positive. Electron microscope see the tumor cells within the micro-filaments. Conclusions Both immunohistochemical staining and ultrastructure observation support the origin and malignant features of myoepithelial tumor.