Department of Urology, Fudan University Shanghai Cancer Centre, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
Histopathology. 2014 Nov;65(5):658-66. doi: 10.1111/his.12448. Epub 2014 Aug 6.
To elucidate diagnostic criteria for spiradenocarcinoma, cylindrocarcinoma and spiradenocylindrocarcinoma, and to emphasize correlations between clinical behaviour and variable morphological patterns.
We investigated the clinicopathological and immunophenotypic features of nine cases. There were five men and four women, with ages ranging from 58 years to 82 years. The tumour size varied from 10 mm to 50 mm. The head and neck were most commonly involved. Three cases of spiradenocarcinoma and three cases of cylindrocarcinoma showed a salivary gland-type basal cell adenocarcinoma-like pattern, low-grade (BCAC-LG) and/or high grade (BCAC-HG). The remaining three cases of spiradenocarcinoma showed adenocarcinoma in situ, with invasive adenocarcinoma being seen in one of these cases. PAS staining revealed loss of the PAS-positive hyaline sheath in malignant zones of cylindrocarcinoma. p53 staining was variably positive in the malignant components of all cases. Follow-up was available for all patients, ranging from 5 months to 107 months. Two patients died of disease, one experienced recurrence, and one died of an unrelated cause.
Patients with BCAC-LG have a better prognosis. BCAC-HG is more likely to be found in cylindrocarcinoma, and its clinical behaviour seems to be more aggressive. Close follow-up for early detection of recurrence and metastases is strongly recommended.
阐明螺旋腺瘤、圆柱瘤和螺旋圆柱瘤的诊断标准，并强调临床行为与各种形态模式之间的相关性。
我们研究了 9 例病例的临床病理和免疫表型特征。患者为 5 男 4 女，年龄 58 至 82 岁。肿瘤大小从 10 毫米至 50 毫米不等。头颈部最常受累。3 例螺旋腺瘤和 3 例圆柱瘤表现出唾液腺型基底细胞腺瘤样模式，低级别（BCAC-LG）和/或高级别（BCAC-HG）。其余 3 例螺旋腺瘤表现为原位腺癌，其中 1 例有浸润性腺癌。PAS 染色显示圆柱瘤恶性区的 PAS 阳性透明鞘丢失。所有病例的恶性成分中 p53 染色均不同程度阳性。所有患者均有随访，随访时间从 5 个月至 107 个月不等。2 例患者死于疾病，1 例复发，1 例死于无关原因。
BCAC-LG 患者预后较好。BCAC-HG 更可能发生在圆柱瘤中，其临床行为似乎更具侵袭性。强烈建议密切随访，以早期发现复发和转移。
