Song Lin, Cheng Xian-Kui, Yang Zhen, Ji Xiao-Bin, Zhou Xiao-Li, Cheng Hong-Xia, Lin Dong-Liang
Department of Pathology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, China.
Department of Pathology, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, 266003, China.
Virchows Arch. 2023 Apr;482(4):789-795. doi: 10.1007/s00428-022-03456-8. Epub 2022 Nov 21.
Salivary gland-type intraductal carcinoma (IC) is a rare malignant salivary gland neoplasm. Primary salivary gland-type IC has never been described in the lung. Herein, we present a primary pulmonary IC in a 63-year-old woman. The tumor originated in the bronchus wall of the right middle lobe. The tumor consisted of two histological types, intercalated component and oncocytic component. The intercalated component showed tubular/cystic pattern composed of column to cube-shaped cells and scattered mucous cells. The oncocytic component showed solid nests composed of large cells with abundant eosinophilic granular cytoplasm. Immunohistochemically, both histological components were positive for cytokeratin 7 (CK7), S-100 protein, SOX10, and mammaglobin. The rimming myoepithelial cells were highlighted by p63 and smooth muscle actin (SMA). The tumor cells were negative for androgen receptor (AR), HER-2, Dog-1, TTF-1, napsin A, GCDFP-15, and GATA3. In the present case, we detected KIAA1217::RET fusion via DNA-based next-generation sequencing (NGS) and RT-PCR, which established the diagnosis of IC at a molecular level. The present case expands the categories of bronchopulmonary salivary gland-type tumors.
涎腺型导管内癌(IC)是一种罕见的涎腺恶性肿瘤。原发性涎腺型IC从未在肺部被描述过。在此,我们报告一例63岁女性的原发性肺IC。肿瘤起源于右中叶支气管壁。肿瘤由两种组织学类型组成,即闰管样成分和嗜酸性细胞成分。闰管样成分呈由柱状至立方状细胞和散在黏液细胞组成的管状/囊性结构。嗜酸性细胞成分呈由具有丰富嗜酸性颗粒状胞质的大细胞组成的实性巢状结构。免疫组化显示,两种组织学成分细胞角蛋白7(CK7)、S-100蛋白、SOX10和乳腺珠蛋白均呈阳性。边缘肌上皮细胞p63和平滑肌肌动蛋白(SMA)呈阳性。肿瘤细胞雄激素受体(AR)、HER-2、Dog-1、甲状腺转录因子-1(TTF-1)、 napsin A、GCDFP-15和GATA3均为阴性。在本病例中,我们通过基于DNA的二代测序(NGS)和逆转录聚合酶链反应(RT-PCR)检测到KIAA1217::RET融合,这在分子水平上确立了IC的诊断。本病例扩展了支气管肺涎腺型肿瘤的范畴。