Michal M, Skálová A, Simpson R H, Raslan W F, Curík R, Leivo I, Mukensnábl P
Department of Pathology, Medical Faculty of Charles University in Pilsen, Pilsen, Czech Republic.
Histopathology. 1999 Dec;35(6):495-501. doi: 10.1046/j.1365-2559.1999.00792.x.
We report a review of our institutional and consultation files in order to select cases of hitherto unrecognized type of adenocarcinoma occurring in the tongue.
Eight cases of a characteristic adenocarcinoma of the tongue resembled solid and follicular variants of the papillary carcinoma of the thyroid. All the tumours were unencapsulated and were divided by fibrous septa into lobules. Major parts of the lesions were composed of areas with solid and microcystic growth patterns. The most striking cytological feature was that the tumour nuclei were pale-staining with a 'ground glass' quality, and they often appeared to overlap. Immunohistochemically, the tumours expressed cytokeratin and S100 protein and, focally, actin; thyroglobulin was negative. Ultrastructurally the cells had clefted nuclei, and the cytoplasm contained a few mitochondria, lysosomes and Golgi apparatus. Many tumour cells had combined features of both myoepithelial and secretory differentiation-well formed microvilli on their apical borders and bundles of microfilaments. At first presentation, all eight patients had metastases in the regional neck lymph nodes, but all are alive 2-6 years after the initial excision and irradiation.
We describe a distinctive type of adenocarcinoma of the tongue, for which we propose the name cribriform adenocarcinoma of the tongue (CAT). CAT usually presents with metastases in the neck lymph nodes at the time of presentation. We hypothesize that the tumour might arise from the thyroglossal duct anlage.
我们回顾了本机构的病例及会诊资料，以筛选出迄今为止未被认识的发生于舌部的腺癌病例。
8例具有特征性的舌腺癌，类似于甲状腺乳头状癌的实性和滤泡样变型。所有肿瘤均无包膜，被纤维间隔分隔成小叶。病变的主要部分由实性和微囊状生长模式的区域组成。最显著的细胞学特征是肿瘤细胞核淡染，呈“毛玻璃”样，且常相互重叠。免疫组化显示，肿瘤表达细胞角蛋白和S100蛋白，局灶性表达肌动蛋白；甲状腺球蛋白阴性。超微结构上，细胞有核裂，胞质内含有少量线粒体、溶酶体和高尔基体。许多肿瘤细胞兼具肌上皮和分泌性分化的特征——顶端边界有发育良好的微绒毛和成束的微丝。初次就诊时，所有8例患者颈部区域淋巴结均有转移，但在初次切除和放疗后2至6年，所有患者均存活。
我们描述了一种独特的舌腺癌类型，为此我们提议将其命名为舌筛状腺癌（CAT）。CAT通常在就诊时即伴有颈部淋巴结转移。我们推测该肿瘤可能起源于甲状舌管原基。
