Zhu Guochen, Sun Xiaofeng
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2014 Jul;28(14):1040-3.
To improve recognization of clinical, imaging and pathological characteristics of basal cell adenoma (BCA) of parotid gland.
We collected and analyzed the data of the clinical manifestation, imaging features, histological and immunohistochemical characteristics of BCA of parotid gland (n = 9).
Among 9 patients, 2 male, 7 female, and the average age was 55.2 (from 34 to 66 years). The clinical manifestation showed the painless mass in the parotid region. Seven cases underwent CT and other 2 cases underwent MRI. Imaging showed all tumors were located in the superficial lobe, roughly spherical and non-lobulated in shape, with well-defined boundary. The maximal diameter was less than 30 mm. Seven cases showed slightly high density shadow of soft tissue on plain CT. Compared with the parotid signal intensity, two cases showed hypointensity on T1WI and high signal on T2WI. All lesions showed obvious enhancement on delayed contrast CT or MRI. Cystic changes occurred in two cases. Gross observation: the tumors were solid in section, grey, medium in nature and clear with the surrounding tissues. Cystic changes occurred in the superficial region of superficial lobe of two cases. The capsule of tumor was well circumscribed in 8 cases and focally involved in another case. Microscopy: The parenchyma of BCA was mainly composed of basaloid cells, with myoepithelial cells palisading at the periphery of the epithelial nests. Basal membrane separated the parenchyma from the stromal, the latter lacking the myxochondroid matrix. Immunohistochemistry: basaloid cells were positive for CKpan, CD117 and CKL, while myoepithelial cells were positive for P63, SMA, and calponin. The Ki-67 lablel ing index of tumour cell was 0-4%. All patients performed superficial lobe parotidectomy and tumor dissection, and they recovered well postoperatively without tumor recurrence or malignancy.
The BCA of parotid gland has distinctive imaging and pathological features with favourable postoperative prognosis.
提高对腮腺基底细胞腺瘤(BCA)临床、影像学及病理特征的认识。
收集并分析9例腮腺BCA的临床表现、影像学特征、组织学及免疫组化特征数据。
9例患者中,男性2例,女性7例,平均年龄55.2岁(34~66岁)。临床表现为腮腺区无痛性肿块。7例行CT检查,2例行MRI检查。影像学表现为所有肿瘤均位于浅叶,大致呈球形,无分叶,边界清晰。最大直径小于30mm。7例平扫CT显示软组织密度略高影。与腮腺信号强度相比,2例T1WI呈低信号,T2WI呈高信号。所有病变在延迟增强CT或MRI上均表现为明显强化。2例出现囊性变。大体观察:肿瘤切面呈实性,灰白色,质地中等,与周围组织分界清晰。2例浅叶浅部区域出现囊性变。8例肿瘤包膜完整,1例局部受累。显微镜检查:BCA实质主要由基底样细胞组成,肌上皮细胞在上皮巢周边呈栅栏状排列。基底膜将实质与间质分隔,间质缺乏黏液软骨样基质。免疫组化:基底样细胞CKpan、CD117和CKL阳性,肌上皮细胞P63、SMA和钙调蛋白阳性。肿瘤细胞Ki-67标记指数为0~4%。所有患者均行浅叶腮腺切除术及肿瘤剥离术,术后恢复良好,无肿瘤复发及恶变。
腮腺BCA具有独特的影像学及病理特征,术后预后良好。