Mills S E, Fechner R E
Am J Surg Pathol. 1984 Sep;8(9):677-85.
Seven patients with middle ear adenomas (MEA) are presented. MEA are cytologically stereotyped neoplasms with a spectrum of architectural patterns. All tumors were composed of uniform, round, or ovoid cells that resembled normal middle ear epithelium. The histologic patterns varied from tumor to tumor and within a single lesion. Broad sheets of tightly packed cells were commonly present, but glandular and cribriform areas were also frequent. Complex, interdigitating trabeculae, rows of individual cells, and dissociated cells were sometimes seen. Grimelius argyrophil stains were focally positive in three of five stained tumors, but Churukian-Schenk argyrophil preparations demonstrated only rare positive cells in two of these cases. Lysozyme was demonstrable immunohistochemically in each tumor. Lysozyme is present in normal middle ear epithelium and may be a useful marker for MEA, since the tumor is apparently derived from these cells. The clinical features of the seven cases that we report are combined with 44 MEA from the literature. MEA seldom recurs after excision and very rarely invades bone. No patient died of disease. The clinical and histologic distinction of these tumors from plasmacytoma, paraganglioma, ceruminoma, carcinoid tumor, and papillary carcinoma is discussed.
本文报告了7例中耳腺瘤（MEA）患者。MEA是一种细胞形态固定的肿瘤，具有多种结构模式。所有肿瘤均由形态一致的圆形或卵圆形细胞组成，这些细胞类似于正常中耳上皮细胞。不同肿瘤之间以及单个肿瘤内部的组织学模式各不相同。通常可见大片紧密排列的细胞，但腺性和筛状区域也较为常见。有时还可见复杂的相互交错的小梁、单行细胞和成簇的散在细胞。在5例进行了嗜银染色的肿瘤中，有3例呈局灶性阳性，但在其中2例中，Churukian-Schenk嗜银染色仅显示罕见的阳性细胞。免疫组织化学显示，每例肿瘤中溶菌酶均呈阳性。溶菌酶存在于正常中耳上皮细胞中，可能是MEA的一个有用标志物，因为该肿瘤显然起源于这些细胞。我们报告的7例病例的临床特征与文献中报道的44例MEA病例相结合。MEA切除后很少复发，极少侵犯骨质。没有患者死于该疾病。本文还讨论了这些肿瘤与浆细胞瘤、副神经节瘤、耵聍腺瘤、类癌和乳头状癌在临床和组织学上的鉴别。
