Department of Pathology, Fudan University Shanghai Cancer Hospital, Shanghai, China.
Pathol Int. 2012 Jan;62(1):55-9. doi: 10.1111/j.1440-1827.2011.02746.x. Epub 2011 Nov 25.
Myoepithelial carcinoma displaying exclusively myoepithelial differentiation mainly occurs in the salivary glands and breasts, and is considered extremely rare in the trachea. We present the first documented case of a primary myoepithelial carcinoma in the trachea. The patient was a 23-year-old man who presented with shortness of breath and cough for four months. Bronchoscopy and computed tomographic (CT) scan revealed an intraluminal mass in the trachea. A standard sleeve of trachea resection with end-to-end reconstruction was performed. The tumor was mainly composed of spindle cells and epithelioid cells which exhibited relatively uniform nuclei with finely distributed chromatin and inconspicuous nucleoli, suggesting that it may arise from benign myoepithelioma. Moreover, the tumor displayed marked cytologic atypia and an infiltrative tumor border in some areas, suggesting that it was a malignant tumor. Immunohistochemically, the tumor cells were diffusely positive for AE1/AE3, Vimentin and myoepithelial makers (Calponin, P63 and GFAP). The patient's postoperative course was uneventful with no evidence of recurrence at six months after surgery.
主要表现为肌上皮分化的肌上皮癌主要发生在唾液腺和乳腺，在气管中被认为极为罕见。我们报告首例气管原发性肌上皮癌。患者为 23 岁男性，因呼吸困难和咳嗽 4 个月就诊。支气管镜和计算机断层扫描（CT）显示气管腔内肿块。行标准气管袖状切除术端端吻合术。肿瘤主要由梭形细胞和上皮样细胞组成，细胞核相对均匀，染色质分布精细，核仁不明显，提示可能来源于良性肌上皮瘤。此外，肿瘤在某些区域表现出明显的细胞学异型性和浸润性肿瘤边界，提示为恶性肿瘤。免疫组织化学染色显示肿瘤细胞弥漫性表达 AE1/AE3、波形蛋白和肌上皮标志物（钙调蛋白、P63 和 GFAP）。患者术后无并发症，术后 6 个月无复发证据。
