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累及腮腺和甲状腺的未分化恶性肿瘤：取材及PAX8交叉反应可能掩盖淋巴瘤的诊断

Undifferentiated Malignant Neoplasm Involving Parotid and Thyroid: Sampling and PAX8 Cross-Reactivity Can Obscure the Diagnosis of Lymphoma.

作者信息

Hubbard Elizabeth W, Nodit Laurentia, Van Meter Stuart

机构信息

Department of Pathology, University of Tennessee Graduate School of Medicine, Knoxville, TN, USA.

出版信息

Case Rep Pathol. 2016;2016:3291549. doi: 10.1155/2016/3291549. Epub 2016 Dec 18.

DOI:10.1155/2016/3291549
PMID:28078156
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5203867/
Abstract

Poorly differentiated malignant neoplasia arising within the head and neck region may originate from diverse sources. We report a case of a cytologically undifferentiated malignant neoplasm clinically presenting as masses involving thyroid and parotid. Although PAX8 was immunoreactive and thus worrisome for anaplastic thyroid carcinoma, the tumor was eventually proven to represent PAX5 positive diffuse large B-cell lymphoma expressing cross-reactivity with polyclonal PAX8 antibody. Cross-reactivity between commercially available polyclonal PAX8 and PAX5 immunostains has been described in the literature but is not widely known, and it is a potential pitfall for making a misdiagnosis. This distinction can have importance in selection of subsequent clinical therapy and should be considered in choice of immunohistochemical stains for diagnostic purposes.

摘要

头颈部区域出现的低分化恶性肿瘤可能起源于多种来源。我们报告一例细胞学上未分化的恶性肿瘤，临床上表现为累及甲状腺和腮腺的肿块。尽管PAX8呈免疫反应性，因此令人担忧为间变性甲状腺癌，但最终证实该肿瘤为PAX5阳性弥漫性大B细胞淋巴瘤，与多克隆PAX8抗体存在交叉反应。文献中已描述了市售多克隆PAX8和PAX5免疫染色之间的交叉反应，但并不广为人知，这是误诊的一个潜在陷阱。这种区分在后续临床治疗的选择中可能很重要，并且在选择用于诊断目的的免疫组化染色时应予以考虑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9d5/5203867/7f255eb74274/CRIPA2016-3291549.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9d5/5203867/5a4074b0f216/CRIPA2016-3291549.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9d5/5203867/312c1b874015/CRIPA2016-3291549.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9d5/5203867/64e6e9612abf/CRIPA2016-3291549.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9d5/5203867/7f255eb74274/CRIPA2016-3291549.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9d5/5203867/5a4074b0f216/CRIPA2016-3291549.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9d5/5203867/312c1b874015/CRIPA2016-3291549.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9d5/5203867/64e6e9612abf/CRIPA2016-3291549.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9d5/5203867/7f255eb74274/CRIPA2016-3291549.004.jpg

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本文引用的文献

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2
Value of PAX 8 immunostaining in tumor diagnosis: a review and update.PAX8 免疫组化在肿瘤诊断中的价值：综述与更新。
Adv Anat Pathol. 2012 May;19(3):140-51. doi: 10.1097/PAP.0b013e318253465d.
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N-terminal PAX8 polyclonal antibody shows cross-reactivity with N-terminal region of PAX5 and is responsible for reports of PAX8 positivity in malignant lymphomas.
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Mod Pathol. 2012 Feb;25(2):231-6. doi: 10.1038/modpathol.2011.162. Epub 2011 Oct 28.
4
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Hum Pathol. 2011 Dec;42(12):1873-7. doi: 10.1016/j.humpath.2011.02.004. Epub 2011 Jun 12.
5
A comprehensive analysis of PAX8 expression in human epithelial tumors.PAX8 在人类上皮性肿瘤中的表达的综合分析。
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