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[黏液样肾上腺皮质腺瘤的临床病理特征]

[Clinicopathologic features of myxoid adrenocortical adenomas].

作者信息

Wu H M, Liu C, Liu X H, Yao J, Liao J Q, Chen Y, Mei P, Huang L Y, Liu Y H

机构信息

Department of Pathology, Guangdong General Hospital; Guangdong Academy of Medical Sciences, Guangzhou 510080, China.

出版信息

Zhonghua Bing Li Xue Za Zhi. 2018 Jul 8;47(7):527-530. doi: 10.3760/cma.j.issn.0529-5807.2018.07.009.

Abstract

To study the clinicopathologic characteristics, immunophenotype, pathologic diagnosis and differential diagnosis of myxoid adrenocortical adenomas. The clinical data, histological features and immunohistochemical results of 4 cases of myxoid adrenocortical adenomas were analyzed, which were collected from January 2014 to December 2016 at Guangdong General Hospital, with review of literature. Four cases of myxoid adrenocortical adenomas were presented. The patients ages ranged from 26 to 45 years (mean =35 years). Microscopically, it showed a typical morphology, characterized by small-sized tumor cell cords or pseudo-glands embedded in an abundant extracellular myxoid matrix. Immunohistochemical staining showed tumor cells were strongly positive for Melan A, vimentin and focally for α-inhibin, one case showed strong and diffuse positivity for CAM5.2, and two cases showed diffuse positivity for synaptophysin, while negative for CgA, S-100 protein, epithelial antigen, CK7, CK20 and CKpan. Myxoid adrenocortical adenomas are extremely rare, which may cause confusion with metastatic well-differentiated neuroendocrine tumours, sex cord-stromal tumoursor metanephric adenoma. Recognition of this entity would be beneficial for pathologists to avoid misdiagnosis, and unnecessary treatment.

摘要

研究黏液样肾上腺皮质腺瘤的临床病理特征、免疫表型、病理诊断及鉴别诊断。分析2014年1月至2016年12月在广东省人民医院收集的4例黏液样肾上腺皮质腺瘤的临床资料、组织学特征及免疫组化结果,并复习相关文献。报道4例黏液样肾上腺皮质腺瘤。患者年龄26~45岁(平均35岁)。镜下显示典型形态,以嵌入丰富细胞外黏液样基质中的小肿瘤细胞条索或假腺管为特征。免疫组化染色显示肿瘤细胞Melan A、波形蛋白呈强阳性,α-抑制素局灶阳性,1例CAM5.2呈强弥漫阳性,2例突触素呈弥漫阳性,而嗜铬粒蛋白A、S-100蛋白、上皮抗原、CK7、CK20及细胞角蛋白广谱均为阴性。黏液样肾上腺皮质腺瘤极为罕见,可能与转移性高分化神经内分泌肿瘤、性索间质肿瘤或后肾腺瘤混淆。认识这一实体对病理学家避免误诊及不必要的治疗有益。

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