Department of Pathology, Faculty of Medicine, Oita University, Yufu, Japan.
APMIS. 2010 May;118(5):401-6. doi: 10.1111/j.1600-0463.2010.02606.x.
We report a case of pulmonary myoepithelial carcinoma with extensive myxohyaline stroma, resembling matrix-producing carcinoma of the breast. A 76-year-old Japanese man presented with a nodular lesion in the left lung (S8), and underwent partial resection of the left lower lobe. Microscopically, the resected tumor was relatively well circumscribed with central hypocellular myxohyaline and peripheral hypercellular area. In the central area, eosinophilic and clear polygonal cells proliferated in a cord-like or reticulated pattern with extensive myxohyaline stroma, while the peripheral area was composed of solid lobules of different shapes and sizes with occasional comedonecrosis. The tumor cells were markedly atypical with frequent mitotic figures. Vascular and lymphatic invasion was evident with regional lymph node metastasis. No squamous or glandular differentiation was evident in the tumor. Immunohistochemical staining implied myoepithelial differentiation. The patient developed multiple brain metastases, and died of the disease 11 months after the surgery. In this report, we discuss the histopathologic uniqueness of the present case together with a review of the literature.
我们报告一例伴广泛黏液样基质的肺肌上皮癌,类似于乳腺的促结缔组织增生型癌。一名 76 岁日本男性因左肺(S8)结节性病变就诊,并接受了左下肺叶部分切除术。镜下,切除的肿瘤边界相对清楚,中央区为细胞稀少的黏液样和周边区为细胞丰富区。在中央区,嗜酸性透明多角形细胞呈索状或网状排列,伴有广泛的黏液样基质,而周边区则由不同形状和大小的实性小叶组成,偶尔伴有粉刺样坏死。肿瘤细胞明显异型性,有频繁的有丝分裂象。可见血管和淋巴管侵犯,并伴有区域淋巴结转移。肿瘤内未见鳞状或腺分化。免疫组织化学染色提示肌上皮分化。该患者出现多发脑转移,术后 11 个月死于该病。在本报告中,我们结合文献复习讨论了本例的组织病理学特征。