Niffenegger J H, Jakobiec F A, Shore J W, Albert D M
Massachusetts Eye and Ear Infirmary, Department of Ophthalmology and Harvard Medical School, Boston 02114.
Ophthalmology. 1992 Apr;99(4):567-74. doi: 10.1016/s0161-6420(92)31948-7.
A 50-year-old man presented with a rapidly growing mass in the area of the right lacrimal gland. An initial erroneous histopathologic diagnosis of a pleomorphic adenoma made on a small-incisional biopsy was later corrected to a malignant rhabdoid tumor when a wide local excision of the tumor was performed. The tumor was composed predominantly of dyscohesive, globoid, and eosinophilic cells, which frequently contained cytoplasmic inclusions. These were demonstrated to be composed of whorls of intermediate vimentin filaments. The tumor cells expressed epithelial membrane antigen as well as cytokeratin. Ultrastructurally, they displayed intercellular junctions and interrupted segments of linear basement membrane material. These findings, together with the development of the lesion within the parenchyma of the lacrimal gland, are suggestive of an epithelial origin. The patient was treated with radical surgery and adjunctive radiotherapy and chemotherapy, which are the recommended treatment modalities for this highly malignant tumor.
一名50岁男性患者,右泪腺区域出现一个迅速生长的肿块。最初在小切口活检时对其进行的组织病理学诊断为多形性腺瘤,但后来在对肿瘤进行广泛局部切除后,诊断更正为恶性横纹肌样瘤。肿瘤主要由散在的、球状的嗜酸性细胞组成,这些细胞经常含有细胞质内含物。经证实,这些内含物由中间丝波形蛋白丝的漩涡状结构组成。肿瘤细胞表达上皮膜抗原以及细胞角蛋白。在超微结构上,它们显示出细胞间连接和线性基底膜物质的中断片段。这些发现,连同病变在泪腺实质内的发展情况,提示其起源于上皮。该患者接受了根治性手术以及辅助放疗和化疗,这些是针对这种高度恶性肿瘤推荐的治疗方式。