Osaki T, Hirota J, Ohno A, Tatemoto Y
Department of Oral Surgery, Kochi Medical School, Japan.
Cancer. 1990 Oct 15;66(8):1796-801. doi: 10.1002/1097-0142(19901015)66:8<1796::aid-cncr2820660826>3.0.co;2-k.
A rare tumor not easily classifiable among published histologic categories for salivary gland tumors is reported. The neoplasm developed within the submandibular gland of a 78-year-old woman with invasion of the mandible and metastasis to regional lymph nodes. Histopathologically, cuboidal cells possessing clear cytoplasm and displaced round nuclei proliferated and exhibited an adenomatous pattern. Many cystic spaces surrounded by tumor cell strands were seen, mucus substance filled in the cystic spaces, and the tumor cells seemed mucus-secreting, but neither epidermoid cells nor papillary appearance could be observed. Electromicroscopically, numerous mucous droplets of low electron density were prominent in the cytoplasm, and the tumor cells had sparse irregular microvilli on the luminal surface. Mucin histochemistry, including paradoxical concanavalin A staining, revealed that the tumor cells contained neutral and acid mucins, and these were identified as class II and III mucosubstances. No other neoplastic lesion, except recurrent metastatic neck nodes, has been detected 6 years after the first examination, and it seems that the tumor is a rare primary mucinous adenocarcinoma of the submandibular gland.
报告了一种罕见肿瘤，在已发表的唾液腺肿瘤组织学分类中不易归类。该肿瘤发生于一名78岁女性的下颌下腺，侵犯下颌骨并转移至区域淋巴结。组织病理学上，具有透明细胞质和移位圆形细胞核的立方体细胞增生并呈腺瘤样结构。可见许多被肿瘤细胞条索围绕的囊腔，囊腔内充满黏液物质，肿瘤细胞似乎能分泌黏液，但未观察到表皮样细胞或乳头状外观。电镜下，细胞质内可见大量低电子密度的黏液滴，肿瘤细胞在腔面有稀疏不规则的微绒毛。黏液组织化学，包括伴刀豆球蛋白A反常染色，显示肿瘤细胞含有中性和酸性黏液，这些被鉴定为Ⅱ类和Ⅲ类黏液物质。首次检查6年后，除颈部复发性转移淋巴结外，未检测到其他肿瘤性病变，该肿瘤似乎是一种罕见的下颌下腺原发性黏液腺癌。
