Zhu Miao-Miao, Cui Hong-Guang, Teng Xiao-Dong
Department of Ophthalmology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
Department of Pathology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
Onco Targets Ther. 2015 May 11;8:1017-24. doi: 10.2147/OTT.S82168. eCollection 2015.
Primary ductal adenocarcinoma (PDA) of the lacrimal gland is a rare malignant epithelial tumor, and its clinicopathological characteristics are still unclear. This study aimed to report a novel case of PDA of the lacrimal gland in the People's Republic of China, as well as to determine its histopathological and immunohistochemical characteristics to support early diagnosis and direct further therapy.
Clinical data (including ocular examination, computed tomography, magnetic resonance imaging, positron emission tomography, mammography, and serum tumor marker examination) and treatment of a 49-year-old woman with a left lacrimal gland mass, which was diagnosed as PDA of the lacrimal gland, were reported. Histopathological and immunohistochemical studies were performed. Eleven papers regarding this uncommon neoplasm were reviewed.
Histopathologically, most of the tumor cells featured abundant granular eosinophilic cytoplasm, while few of them had a frothy appearance. The mass showed breast ductal carcinoma-like structural features, which most commonly demonstrated central necrosis, while less of these features showed cord-like infiltration. Immunohistochemically, the tumor cells were positive for GCDFP-15, CK 18 (++), AR (90%), Her-2 (+++), P53 (100%), and Ki-67 (with a proliferation index approximately 60%), while they were negative for ER, PR, P63, calponin, and CD 117.
This was the first Chinese case of PDA of the lacrimal gland that had been reported. We suggested that GCDFP-15, AR, and Her-2 should be tested as biomarkers for ductal adenocarcinoma of lacrimal gland to confirm diagnosis, guide therapy, and further predict prognosis.
泪腺原发性导管腺癌（PDA）是一种罕见的恶性上皮性肿瘤，其临床病理特征仍不明确。本研究旨在报告中华人民共和国一例新的泪腺PDA病例，并确定其组织病理学和免疫组化特征，以支持早期诊断并指导进一步治疗。
报告了一名49岁左侧泪腺肿物女性患者的临床资料（包括眼部检查、计算机断层扫描、磁共振成像、正电子发射断层扫描、乳腺钼靶检查和血清肿瘤标志物检查）及治疗情况，该患者被诊断为泪腺PDA。进行了组织病理学和免疫组化研究。回顾了11篇关于这种罕见肿瘤的文献。
组织病理学上，大多数肿瘤细胞具有丰富的颗粒状嗜酸性细胞质，少数呈泡沫状外观。肿物呈现乳腺导管癌样结构特征，最常见的是中央坏死，较少见的是条索状浸润。免疫组化方面，肿瘤细胞GCDFP-15、CK 18（++）、AR（90%）、Her-2（+++）、P53（100%）和Ki-67（增殖指数约60%）呈阳性，而ER、PR、P63、钙调蛋白和CD 117呈阴性。
这是首次报道的中国泪腺PDA病例。我们建议检测GCDFP-15、AR和Her-2作为泪腺导管腺癌的生物标志物，以确诊、指导治疗并进一步预测预后。
