Zhang C Y, Gu T, Xia S, Wang Y, Li J
Department of Oral Pathology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine & College of Stomatology, Shanghai Jiao Tong University & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai 200011, China.
Department of Oral Pathology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210018, China.
Zhonghua Kou Qiang Yi Xue Za Zhi. 2024 May 9;59(5):479-485. doi: 10.3760/cma.j.cn112144-20231211-00290.
To analyze the clinicopathological features of salivary carcinoma showing thymus-like differentiation(CASTLE). Cases diagnosed with salivary CASTLE from January 2020 to December 2023 were collected and selected from the Department of Oral Pathology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. A total of 7 cases of salivary CASTLE were identified. All the cases originated from parotid. There were 3 males and 4 females. The patients' age range was 11-70 years.The clinical, microscopic, immunohistochemical and prognostic features of these cases were analyzed. The duration of disease ranged from 1 month to 1 year, and 1 patient had facial numbness and 1 with swelling sensation occasionally. Radiographically, 4 cases showed malignant signs. Microscopically, 4 cases involved in parotid gland, and all the tumors had different degrees of lymphoid tissue background. The tumor cells arranged in nests, 5 cases with lymphoepithelial carcinoma-like and 2 cases with squamous cell carcinoma morphology. The tumor cells expressed CD5 and CD117 proteins diffusely in lymphoepithelial carcinoma-like cases. However, the tumor cells expressed CD5 diffusely and CD117 focally in cases with squamous cell carcinoma morphology. All the cases had no Epstein-Barr virus infection. Among the 6 patients with follow-up information, all of them underwent postoperative radiotherapy, and none of them had local recurrence and lymph node metastasis. Salivary CASTLE is a rare tumor, it should be distinguished from lymphoepithelial carcinoma and squamous cell carcinoma. The patients often have better prognosis and CD5 protein expression has a valuable role in the differential diagnosis.
分析具有胸腺样分化的唾液腺癌（CASTLE）的临床病理特征。收集并选取2020年1月至2023年12月在上海交通大学医学院附属第九人民医院口腔病理科诊断为唾液腺CASTLE的病例。共鉴定出7例唾液腺CASTLE。所有病例均起源于腮腺。男性3例，女性4例。患者年龄范围为11至70岁。分析这些病例的临床、显微镜、免疫组织化学和预后特征。病程为1个月至1年，1例患者偶尔有面部麻木，1例有肿胀感。影像学上，4例显示恶性征象。显微镜下，4例累及腮腺，所有肿瘤均有不同程度的淋巴组织背景。肿瘤细胞呈巢状排列，5例呈淋巴上皮癌样，2例呈鳞状细胞癌形态。在淋巴上皮癌样病例中，肿瘤细胞弥漫性表达CD5和CD117蛋白。然而，在鳞状细胞癌形态的病例中，肿瘤细胞弥漫性表达CD5，局灶性表达CD117。所有病例均无EB病毒感染。在有随访信息的6例患者中，所有患者均接受了术后放疗，无一例出现局部复发和淋巴结转移。唾液腺CASTLE是一种罕见肿瘤，应与淋巴上皮癌和鳞状细胞癌相鉴别。患者通常预后较好，CD5蛋白表达在鉴别诊断中具有重要作用。
