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舌手术标本中的多灶性坏死性涎腺化生:一项免疫组织化学研究

Multifocal Necrotizing Sialometaplasia in the Tongue Surgical Specimen: An Immunohistochemical Study.

作者信息

Marques Marcelo Borges, Posantes Gabriela Esperanza Maradiaga, Gonçalves Luana Stefanie Silvino, da Silva Anderson Tangerino Ferreira, Silveira Heitor Albergoni, Chahud Fernando, León Jorge Esquiche

机构信息

Oral Medicine, Department of Diagnosis and Surgery, Araraquara Dental School, FOAr/UNESP, Araraquara, São Paulo, Brazil.

Oral Pathology, Department of Stomatology, Public Oral Health, and Forensic Dentistry, Ribeirão Preto Dental School (FORP/USP), University of São Paulo, Ribeirão Preto, São Paulo, Brazil.

出版信息

Head Neck Pathol. 2025 Feb 5;19(1):18. doi: 10.1007/s12105-025-01756-4.

DOI:10.1007/s12105-025-01756-4
PMID:39907884
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11799453/
Abstract

BACKGROUND

Necrotizing sialometaplasia (NSM) is a rare self-limiting inflammatory lesion, with most cases affecting the minor salivary glands, especially those located in the palate (70%). To date, about 261 cases of NSM have been reported. Of them, 7 cases affected the tongue; 37 cases occurred after surgery; and 17 cases showed association with neoplasms.

METHODS

A 50-year-old male patient was diagnosed with squamous cell carcinoma (SCC) of the tongue. After surgical excision, the tumor diagnosis was well-differentiated SCC with a close surgical margin. Re-excision of the margin was indicated.

RESULTS

Microscopically, the surgical margin showed neither residual SCC nor epithelial dysplasia. However, it was possible to observe 7 foci containing typical areas of NSM distributed throughout the surgical specimen, which, by immunohistochemistry, revealed a glandular nature with presence of myoepithelial cells.

CONCLUSION

We present here an unusual multifocal NSM affecting the tongue at the site of a prior resection for SCC with close margins, which, to the best of our knowledge, has not been reported to date.

摘要

背景

坏死性涎腺化生(NSM)是一种罕见的自限性炎症性病变,大多数病例累及小涎腺,尤其是位于腭部的小涎腺(70%)。迄今为止,已报道约261例NSM。其中,7例累及舌部;37例发生于手术后;17例显示与肿瘤有关。

方法

一名50岁男性患者被诊断为舌鳞状细胞癌(SCC)。手术切除后,肿瘤诊断为高分化SCC,手术切缘接近。需要对切缘进行再次切除。

结果

显微镜下,手术切缘未见残留SCC及上皮发育异常。然而,在整个手术标本中可以观察到7个含有典型NSM区域的病灶,通过免疫组化显示其具有腺性本质且存在肌上皮细胞。

结论

我们在此报告一例不寻常的多灶性NSM,发生于既往因切缘接近而行SCC切除术的舌部,据我们所知,迄今为止尚未见报道。

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本文引用的文献

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Indian J Otolaryngol Head Neck Surg. 2023 Sep;75(3):2302-2305. doi: 10.1007/s12070-023-03609-4. Epub 2023 Feb 27.
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Necrotizing sialometaplasia can hide the presence of salivary gland tumors: A case series.坏死性涎腺化生可能会掩盖唾液腺肿瘤的存在:病例系列研究。
Oral Dis. 2019 May;25(4):1084-1090. doi: 10.1111/odi.13066. Epub 2019 Mar 5.
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Necrotizing sialometaplasia versus invasive carcinoma of the head and neck: the use of myoepithelial markers and keratin subtypes as an adjunct to diagnosis.坏死性涎腺化生与头颈部浸润性癌:使用肌上皮标志物和角蛋白亚型辅助诊断
Histopathology. 2007 Aug;51(2):184-9. doi: 10.1111/j.1365-2559.2007.02762.x.
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Necrotizing sialometaplasia. A clinicopathologic study of sixty-nine cases and review of the literature.坏死性涎腺化生:69例临床病理研究及文献复习
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