Allen M S, Marsh W L
Cancer. 1976 Nov;38(5):2017-21. doi: 10.1002/1097-0142(197611)38:5<2017::aid-cncr2820380525>3.0.co;2-o.
Thirty-four cases of adenoid cyctic carcinoma seen at the University of Virginia Hospital from 1946 to 1974 were reviewed, with special emphasis on lymph node involvement by tumor. Lymph node involvement was found in three cases of primary tumors of the submaxillary gland, and all of the affected lymph nodes were in the immediate vicinity of the primary tumor. Two lymph nodes were involved in two of the cases, and one node was involved in the third case. In all of these lymph nodes, adenoid cystic carcinoma was present in the soft tissue surrounding the node, and the tumor extended into the node. No metastatic tumors were observed in 46 lymph nodes removed incidentally at the time of local excision of the primary tumors in 10 additional cases or in 212 lymph nodes examined after unilateral radical neck dissections in six other cases. Five autopsies in this series showed no lymph node metastases. In this series of cases adenoid cystic carcinoma only invades lymph nodes in the immediate vicinity of the primary tumor. When lymph node involvement does occur, it does not result from embolic lymph node metastasis; rather, a direct invasion of the lymph node from tumor in the perinodal soft tissue occurs. Obviously, this small study does not completely exclude the possibility of embolic metastasis; however, if it does occur, it must be extremely rare.
回顾了1946年至1974年在弗吉尼亚大学医院所见的34例腺样囊性癌病例，特别强调肿瘤的淋巴结受累情况。在3例颌下腺原发性肿瘤中发现有淋巴结受累，所有受累淋巴结均在原发性肿瘤的紧邻区域。其中2例累及2个淋巴结，第3例累及1个淋巴结。在所有这些淋巴结中，腺样囊性癌存在于淋巴结周围的软组织中，且肿瘤延伸至淋巴结内。在另外10例原发性肿瘤局部切除时偶然切除的46个淋巴结中，以及在其他6例单侧根治性颈清扫术后检查的212个淋巴结中，均未观察到转移性肿瘤。该系列中的5例尸检显示无淋巴结转移。在这一系列病例中，腺样囊性癌仅侵犯原发性肿瘤紧邻区域的淋巴结。当确实发生淋巴结受累时，并非由栓塞性淋巴结转移所致；而是肿瘤从淋巴结周围软组织直接侵犯淋巴结。显然，这项小型研究并未完全排除栓塞性转移的可能性；然而，如果确实发生，肯定极为罕见。
