Dardick I, van Nostrand A W
Department of Laboratory Medicine, Ottawa Civic Hospital, Ontario, Canada.
Oral Surg Oral Med Oral Pathol. 1988 Oct;66(4):459-65. doi: 10.1016/0030-4220(88)90269-1.
A specimen of a polymorphous low-grade adenocarcinoma of minor salivary gland origin in the nose, originally diagnosed as an adenoid cystic carcinoma, was examined by electron microscopy. The tumor cells forming narrow, anastomosing trabecular cords in histologic sections were almost exclusively well-differentiated myoepithelial cells when examined with the electron microscope. Adenoidal regions within and between the columns of tumor cells resulted from the production of excessive amounts of basal lamina and glycosaminoglycans. In one focal region, glandular lumina were formed within the trabecular cords and more solid regions of the tumor. By both immunohistochemistry (anticytokeratins and anti-S 100 protein) and electron microscopy, transitions from the principal tumor cells comprising the trabecular cords (myoepithelial cells) to luminal epithelial cells could be detected. Since the patient is free of recurrence or metastases 7 years after limited surgical resection of the tumor, the designation of polymorphous low-grade adenocarcinoma seems quite appropriate.
对一例起源于鼻腔小涎腺的多形性低度腺癌标本进行了电镜检查，该病例最初被诊断为腺样囊性癌。组织学切片中形成狭窄、相互吻合的小梁状条索的肿瘤细胞，在电镜检查时几乎全部为高分化肌上皮细胞。肿瘤细胞柱内及柱间的腺样区域是由过量产生的基底膜和糖胺聚糖所致。在一个局灶区域，小梁状条索及肿瘤更实性区域内形成了腺腔。通过免疫组织化学（抗细胞角蛋白和抗S100蛋白）及电镜检查，均可检测到构成小梁状条索的主要肿瘤细胞（肌上皮细胞）向管腔上皮细胞的转变。由于该患者在肿瘤有限手术切除7年后无复发或转移，多形性低度腺癌这一命名似乎颇为恰当。
