Simpson R H, Clarke T J, Sarsfield P T, Gluckman P G
Postgraduate Medical School, University of Exeter, Devon.
J Clin Pathol. 1991 May;44(5):419-23. doi: 10.1136/jcp.44.5.419.
Four cases of epithelial-myoepithelial carcinoma of the salivary glands arose as painless masses in patients over 60 years old, three in the parotid and one in the submandibular gland. Histologically, all the tumours were composed of small ducts with a double cell lining surrounded by a basement membrane. The inner cells were epithelial and the outer cells myoepithelial, the latter usually possessing clear cytoplasm. There was a variable degree of intervening hyalinised stroma. All the tumours were partly encapsulated, but also displayed local invasiveness. One of the tumours also showed areas of dedifferentiation when it later recurred and metastasised. The other three were apparently cured by initial excision, with adjuvant radiotherapy in one instance. In the past this tumour has been described as clear cell adenoma, and it was only recently that its true malignant nature, albeit low grade, was recognised. Reports of epithelial-myoepithelial carcinoma are still relatively few, with only one case described from Britain. It is recommended that this histologically distinct neoplasm deserves wider recognition.
4例涎腺上皮-肌上皮癌表现为60岁以上患者的无痛性肿块，其中3例位于腮腺，1例位于下颌下腺。组织学上，所有肿瘤均由内衬双层细胞的小导管组成，周围有基底膜。内层细胞为上皮细胞，外层细胞为肌上皮细胞，后者通常具有透明的细胞质。其间有不同程度的玻璃样变性间质。所有肿瘤均部分有包膜，但也表现出局部浸润性。其中1例肿瘤复发并转移时还出现了去分化区域。另外3例经初次切除后明显治愈，其中1例还接受了辅助放疗。过去该肿瘤被描述为透明细胞腺瘤，直到最近才认识到其真正的恶性本质，尽管分级较低。上皮-肌上皮癌的报道仍然相对较少，英国仅描述过1例。建议这种组织学上独特的肿瘤应得到更广泛的认识。
