Dessy E, Braidotti P, Del Curto B, Falleni M, Coggi G, Santa Cruz G, Carai A, Versace R, Pietra G G
Department of Forensic Medicine and Pathology, School of Medicine, University of Cagliari, Italy.
Virchows Arch. 2000 Mar;436(3):289-95. doi: 10.1007/s004280050043.
Peripheral papillary adenomas of the lung are uncommon neoplasms (only ten cases have been described so far in the English literature) composed predominantly of type-II pneumocytes and generally considered benign. We describe here two additional cases of this lung tumor. In both cases histological examination revealed an encapsulated papillary neoplasm with invasion of the capsule and, in one case, invasion of the adjacent alveoli and visceral pleura too. The proliferative index (Ki67) was less than 2% and the epithelial cells were positive for cytokeratins, surfactant apoproteins (SP), and nuclear thyroid transcription factor-1 (TTF- 1). Ultrastructurally, the epithelial cells showed the characteristic surface microvilli and cytoplasmic lamellar inclusions of type-II cells. Review of the literature has revealed two other cases of peripheral papillary adenoma of type-II pneumocytes with infiltrative features. Thus, we propose replacing the term peripheral papillary adenoma with peripheral papillary tumor of undetermined malignant potential.
肺外周乳头状腺瘤是一种罕见的肿瘤（迄今为止英文文献中仅描述了10例），主要由II型肺泡上皮细胞组成，通常被认为是良性的。我们在此描述另外两例这种肺肿瘤。在这两例中，组织学检查均显示为有包膜的乳头状肿瘤，包膜有浸润，在其中一例中，还侵犯了相邻的肺泡和脏层胸膜。增殖指数（Ki67）小于2%，上皮细胞细胞角蛋白、表面活性物质载脂蛋白（SP）和核甲状腺转录因子-1（TTF-1）呈阳性。超微结构上，上皮细胞显示出II型细胞特有的表面微绒毛和胞质板层小体。文献回顾发现另外两例具有浸润特征的II型肺泡上皮细胞外周乳头状腺瘤。因此，我们建议将外周乳头状腺瘤这一术语替换为具有不确定恶性潜能的外周乳头状肿瘤。
