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浸润性分层黏液产生癌:三例临床病理分析。

Invasive stratified mucin-producing carcinoma: a clinicopathological analysis of three cases.

机构信息

Department of Pathology, Anyang Tumor Hospital , Anyang , Henan , China.

出版信息

Cancer Biol Ther. 2019;20(11):1403-1407. doi: 10.1080/15384047.2019.1647054. Epub 2019 Jul 30.

Abstract

: To investigate the clinicopathologic features and immunophenotype of invasive-stratified mucin-producing carcinoma (ISMC). : We retrospectively analyzed three patients who underwent surgery for pathologically confirmed ISMC from January 2017 to December 2017 in Anyang Tumor Hospital. The pathological features, immunophenotype, and prognosis were discussed. : Clinical symptoms and imaging were atypical. Microscopically, the arrangement of tumor cells is close to that of squamous cell carcinoma, showing flake or nested growth. Morphologically, tumor cells were reminiscent of adenocarcinoma. The tumor cells showed abundant intracytoplasmic mucus which routinely created spacing between adjacent nuclei. The nuclei was round or oval with irregular karyotypes, thick nuclear membrane, staining empty light, rough chromatin, visible small nucleoli. Mucous vacuoles or pink-stained foam were visible in the cytoplasm. Mitotic features and apoptotic bodies were seen in the invasive component of all three cases, whereas all but one of these showed a neutrophil-dominant inflammatory cells infiltration. A large number of histocytes were found in the stroma of two cases. Special staining of mucus confirmed the presence of mucus in cytoplasm. Immunohistochemical results showed that tumor cells were strongly and diffusely positive for p16 and CK7 and had high Ki-67 expression. : ISMC is a rare tumor in female genital tract and is often misdiagnosed as squamous cell carcinoma and other cervical cancers. The diagnosis mainly depends on the unique clinicopathologic features together with the immunophenotype. Treatment and prognosis, like other cervical cancer, are mainly based on clinical stages.

摘要

目的

探讨浸润性柱状细胞黏液腺癌(invasive-stratified mucin-producing carcinoma,ISMC)的临床病理特征和免疫表型。

方法

回顾性分析 2017 年 1 月至 2017 年 12 月安阳肿瘤医院经病理证实的 3 例 ISMC 患者的临床资料,讨论其病理特征、免疫表型和预后。

结果

临床症状和影像学表现不典型。镜下,肿瘤细胞排列方式接近鳞状细胞癌,呈片状或巢状生长。形态上,肿瘤细胞类似于腺癌。肿瘤细胞胞质内富含细胞内黏液,常规情况下可在相邻核之间形成间隔。细胞核呈圆形或椭圆形,核型不规则,核膜厚,染色质淡染,粗糙,可见小核仁。细胞质中可见黏液空泡或粉红色染色泡沫。所有 3 例浸润性成分均可见有丝分裂特征和凋亡小体,但除 1 例外,均可见以中性粒细胞为主的炎细胞浸润。2 例肿瘤间质中有大量组织细胞。黏液特殊染色证实细胞质内存在黏液。免疫组化结果显示,肿瘤细胞 p16 和 CK7 弥漫强阳性,Ki-67 高表达。

结论

ISMC 是女性生殖道罕见肿瘤,常误诊为鳞状细胞癌和其他宫颈癌。诊断主要依赖于独特的临床病理特征和免疫表型。治疗和预后与其他宫颈癌相似,主要基于临床分期。

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