Ibrahim R, Bird D J, Sieler M W
Department of Laboratory Service, Harvard Medical School, Boston, Massachusetts.
Ultrastruct Pathol. 1991 Jan-Feb;15(1):69-76. doi: 10.3109/01913129109021305.
A malignant myoepithelioma arising in the submucosal glands of the larynx of a 71-year-old man is reported. The patient presented with a neck mass and massive metastatic involvement of the liver. Light microscopy of a liver biopsy specimen and fine-needle aspiration sample of the neck mass revealed a poorly differentiated carcinoma. Electron microscopic study of a second liver biopsy specimen demonstrated unequivocal features of myoepithelial differentiation; this was further confirmed by the strong cytokeratin and S-100 protein positivity and carcinoembryonic antigen negativity of the tumor cells. Myoepitheliomas are rare tumors, and most reported cases have been benign or of low-grade malignancy. The present case is unique because of its mode of presentation and fulminant course. It also underscores the usefulness of electron microscopy as a diagnostic modality in the work-up of metastatic lesions.
报告了一例发生于一名71岁男性喉部黏膜下腺的恶性肌上皮瘤。患者表现为颈部肿块及肝脏广泛转移。肝脏活检标本和颈部肿块细针穿刺样本的光镜检查显示为低分化癌。对第二份肝脏活检标本进行电镜研究显示出明确的肌上皮分化特征；肿瘤细胞强烈的细胞角蛋白和S-100蛋白阳性以及癌胚抗原阴性进一步证实了这一点。肌上皮瘤是罕见肿瘤，大多数报道的病例为良性或低度恶性。本例因其呈现方式和迅猛病程而独特。它还强调了电镜检查作为转移性病变检查中一种诊断手段的实用性。
