Zhu G C, Sun X F, Xiao D J
Department of Otolaryngology Head and Neck Surgery, Wuxi Second People's Hospital Affiliated with Nanjing Medical University, Wuxi, 214002, China.
Department of Stomatology, Wuxi Second People's Hospital, Affiliated with Nanjing Medical University.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Jul 20;31(14):1093-1096. doi: 10.13201/j.issn.1001-1781.2017.14.010.
To improve recognization of clinical, imaging and pathological characteristics of lymphoepithelial carcinoma (LEC) of the salivary glands.The clinical manifestations, imaging features, histological and immunohistochemical characteristics of LEC of the salivary glands (n = 12) between 2003 and 2013 were retrospectively reviewed. Four cases of male and 8 cases of female were enrolled, and the average age of 53.25 years. Ten lesions were located in the parotid gland, and 2 cases were in the submandibular gland. Two cases were unilateral multiple tumors, 10 cases were unilateral solitary tumor, 4 cases were with cervical lymph node metastasis and 1 case was with peripheral facial paralysis. Ten patients had positive EB VCA IgA test. Homogeneous density and obvious enhancement were achieved in all lesions on CT scan. 8 cases were with irregular shapes, partially or ill-defined margin, and heterogeneous enhancement. Incomplete capsule was found in 4 cases, while no obvious capsule was found in 6 cases. HE staining showed that the infiltrative tumors were formed by the presence of sheets or nests of epithelial cells and interstitial lymphoid tissue. Immunohistochemistry staining revealed that the epithelial cells were reactive for pan CK, the lymphoid cells showed reactivity for both CD20 and CD3 markers. All cases underwent primary tumor and involved gland resection with ipsilateral neck dissection, and postoperative radiotherapy, and 2 cases combined with postoperative chemotherapy. The 3 year survival rate of patients was 75.0%(9/12), and 3 cases died of local recurrence or (and) distant metastasis within 1-2 years of definite diagnosis. LEC of salivary gland is associated with EB virus infection. Most cases present with unilateral solitary mass, and incidence of regional lymph node involvement is high. The imaging characteristics of tumor seem to be malignant on CT scan in most cases. Treatment includes multimodality therapy including surgical resection, neck dissection, and radiotherapy. Local recurrence and distant metastasis are the main causes of death.
提高对涎腺淋巴上皮癌（LEC）临床、影像学及病理特征的认识。回顾性分析2003年至2013年间12例涎腺LEC的临床表现、影像学特征、组织学及免疫组化特点。纳入男性4例，女性8例，平均年龄53.25岁。10个病灶位于腮腺，2例位于颌下腺。2例为单侧多发肿瘤，10例为单侧单发肿瘤，4例伴有颈部淋巴结转移，1例伴有周围性面瘫。10例患者EB VCA IgA检测阳性。CT扫描所有病灶均呈均匀密度且强化明显。8例形态不规则，部分或边界不清，强化不均匀。4例见包膜不完整，6例未见明显包膜。HE染色显示浸润性肿瘤由上皮细胞片层或巢状结构及间质淋巴组织构成。免疫组化染色显示上皮细胞对泛CK呈阳性反应，淋巴细胞对CD20和CD3标志物均呈阳性反应。所有病例均行原发肿瘤及受累腺体切除并同期行同侧颈清扫术，术后放疗，2例术后联合化疗。患者3年生存率为75.0%（9/12），3例在确诊后1 - 2年内死于局部复发或（和）远处转移。涎腺LEC与EB病毒感染有关。多数病例表现为单侧单发肿块，区域淋巴结受累发生率高。多数情况下肿瘤在CT扫描上的影像学特征似为恶性。治疗包括手术切除、颈清扫及放疗等多学科综合治疗。局部复发和远处转移是主要死亡原因。
