Mizutari Kunio, Naganishi Hideki, Tanaka Yoichi
Department of Otolaryngology, Tochigi National Hospital, Tochigi, Japan.
Auris Nasus Larynx. 2005 Sep;32(3):305-8. doi: 10.1016/j.anl.2005.03.006.
Oncocytic carcinoma arising in the submandibular gland is a very rare tumor that has only previously been reported in nine cases. This paper describes an additional case of oncocytic carcinoma in the right submandibular gland. The patient was a 55-year-old Japanese male who was presented with a 3 cm right submandibular mass. Both radical resection of the tumor and right supraomohyoid neck dissection were performed. Histologically, the tumor cells exhibited an abundant eosinophilic cytoplasm, which appeared to be finely granular, and invaded the surrounding tissues. In addition, perineural invasion was also observed. Electron microscopy demonstrated the presence of an abundance mitochondria in the cytoplasm of the tumor cells. However, since the fine structure of cytoplasm was destroyed by fixation and embedding of the tissue for the light microscopy, the cytoplasm of the tumor could not be observed clearly. Immunohistochemically, anti-mitochondrial antibody positivity was evident in the cytoplasm of the tumor cells. Consequently, we diagnosed the mass as oncocytic carcinoma. Usually, electron microscopy is necessary to diagnose oncocytic lesions, but the paraffin-embedded tissue was not suitable for electron microscopy. Immunohistochemistry using an anti-mitochondrial antibody was found to be useful and helpful for the diagnosis of oncocytic lesions.
发生于下颌下腺的嗜酸性细胞癌是一种非常罕见的肿瘤，此前仅有9例报道。本文描述了1例右侧下颌下腺嗜酸性细胞癌的病例。患者为一名55岁的日本男性，右侧下颌下有一个3 cm的肿块。对肿瘤进行了根治性切除，并进行了右侧肩胛舌骨上颈清扫术。组织学上，肿瘤细胞表现出丰富的嗜酸性细胞质，呈细颗粒状，侵犯周围组织。此外，还观察到神经周围侵犯。电子显微镜显示肿瘤细胞的细胞质中有大量线粒体。然而，由于用于光学显微镜检查的组织固定和包埋破坏了细胞质的精细结构，肿瘤的细胞质无法清晰观察。免疫组织化学显示，肿瘤细胞的细胞质中抗线粒体抗体呈阳性。因此，我们将该肿块诊断为嗜酸性细胞癌。通常，诊断嗜酸性细胞病变需要电子显微镜检查，但石蜡包埋组织不适合进行电子显微镜检查。发现使用抗线粒体抗体的免疫组织化学对嗜酸性细胞病变的诊断有用且有帮助。
