Matsumoto Manabu, Sonobe Hiroshi, Furihata Mutsuo, Nonami Yoshiki, Ohmori Yoshinobu, Ohtsuki Yuji
Department of Pathology II, Kochi Medical School, Nankoku, Japan.
Virchows Arch. 2002 Dec;441(6):618-21. doi: 10.1007/s00428-002-0672-3. Epub 2002 Jun 26.
Salivary gland-type mixed tumor primarily arising in the lung is extremely rare. We report here a case of this type of tumor that occurred in the periphery of S4 of the right middle lobe in a 74-year-old man. Light-microscopically, this lung tumor, 15x9mm in size, exhibited almost the same features as those of mixed tumor of the salivary gland intermingled with chondromyxoid stroma, glandular component, solid growth pattern of myoepithelial components and well-developed cartilage formation, exhibiting a sharp margin. Immunohistochemical study revealed that the glandular components in the tumor was positive for thyroid transcription factor-1, TTF-1, a marker of epithelial cells of the thyroid as well as the lung. Furthermore, surface lining cells of the glandular components and luminal contents were positive for surfactant apoprotein A, PE-10, used as a marker of type II alveolar epithelial cells. These findings clearly demonstrate for the first time that glandular epithelial cells in the present salivary gland-type mixed tumor exhibited differentiation toward type II alveolar epithelial cells.
主要起源于肺部的涎腺型混合瘤极为罕见。我们在此报告一例发生于一名74岁男性右中叶S4外周的此类肿瘤。光镜下,该肺肿瘤大小为15×9mm,表现出与涎腺混合瘤几乎相同的特征,伴有软骨黏液样基质、腺性成分、肌上皮成分的实性生长模式以及发育良好的软骨形成,边界清晰。免疫组化研究显示,肿瘤中的腺性成分对甲状腺转录因子-1(TTF-1)呈阳性,TTF-1是甲状腺及肺上皮细胞的标志物。此外,腺性成分的表面衬里细胞和管腔内容物对用作II型肺泡上皮细胞标志物的表面活性蛋白A(PE-10)呈阳性。这些发现首次清楚地表明,当前涎腺型混合瘤中的腺上皮细胞表现出向II型肺泡上皮细胞的分化。