头颈部肌上皮肿瘤需要考虑的十大鉴别诊断。
Top Ten Differentials to Mull Over for Head and Neck Myoepithelial Neoplasms.
机构信息
Head and Neck Pathology Consultations, 22543 Ventura Blvd, Ste 220 PMB1034, 91364, Woodland Hills, CA, USA.
Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
出版信息
Head Neck Pathol. 2023 Mar;17(1):1-15. doi: 10.1007/s12105-022-01502-0. Epub 2023 Mar 16.
BACKGROUND
Myoepithelial neoplasms of the salivary gland are benign or malignant neoplasms composed exclusively of neoplastic myoepithelial cells. These tumors, including the benign myoepithelioma and the malignant counterpart myoepithelial carcinoma, exhibit a wide range of cytomorphologic features and architectural patterns.
METHODS
Review.
RESULTS
Myoepithelial cells can be epithelial, plasmacytoid, clear cell, spindle cell, and/or oncocytic cell, arranging as trabeculae, solid sheets, nests, cords, and/or single cells. A stromal component is commonly but not universally present, Therefore, their differential diagnoses are quite broad, including salivary gland neoplasms especially those with a myoepithelial component, plasmacytoma, melanoma, and various mesenchymal tumors.
CONCLUSION
In this review, we summarize the characteristic histologic features, useful immunohistochemical panel, and common molecular alterations of myoepithelial tumors and their top differential diagnoses. A logical stepwise algorithmic approach and an immunohistochemical panel to include multiple myoepithelial markers are essential to establish the correct diagnosis.
背景
唾液腺肌上皮肿瘤是由单纯的肿瘤性肌上皮细胞组成的良性或恶性肿瘤。这些肿瘤，包括良性肌上皮瘤和恶性肌上皮癌，表现出广泛的细胞形态学特征和结构模式。
方法
回顾。
结果
肌上皮细胞可以是上皮样、浆细胞样、透明细胞样、梭形细胞样和/或嗜酸性粒细胞样，排列成小梁状、实性片状、巢状、条索状和/或单个细胞。通常但并非普遍存在基质成分，因此，其鉴别诊断非常广泛，包括唾液腺肿瘤，特别是具有肌上皮成分的肿瘤、浆细胞瘤、黑色素瘤和各种间叶肿瘤。
结论
在这篇综述中，我们总结了肌上皮肿瘤的特征性组织学特征、有用的免疫组织化学标志物面板以及常见的分子改变及其主要鉴别诊断。逻辑上的分步算法和包括多个肌上皮标志物的免疫组织化学标志物面板对于确立正确的诊断至关重要。
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