Rouse R V, Soetikno R M, Baker R J, Barnard I C, Triadafilopoulos G, Longacre T A
Department of Pathology, Veterans Affairs Medical Center, Palo Alto, California, USA.
Am J Surg Pathol. 1995 Oct;19(10):1191-6. doi: 10.1097/00000478-199510000-00009.
An 81-year-old man with a 3-year history of dysphagia underwent endoscopic resection of a 1-cm-diameter distal esophageal mass. Examination revealed a submucosal neoplasm with a circumscribed growth pattern composed of tubules, cysts, and papillae in association with a marked interstitial lymphoid infiltrate. The cyst lumens and papillae were lined by two to six layers of cytologically bland cuboidal to columnar cells with rare mitotic figures. The basal layer of cells was uniformly positive for smooth-muscle actin. Mucin-positive intracytoplasmic lumens were focally present, but cytoplasmic mucin was not seen. There was no evidence of Barrett's metaplastic epithelium. These features are similar to those in two, possibly three, previously reported cases of esophageal adenomas and bear a resemblance to sialadenoma papilliferum, a rare neoplasm of the minor salivary glands. Their clinicopathologic and immunohistologic features suggest that these neoplasms derive from the submucosal gland ducts. Comparison with the previously reported cases indicates that although the proportions of the various components (tubules, cysts, and papillae) may vary, all cases appear to pursue a slowly growing, clinically indolent course with no evidence of recurrence after complete resection.
一名有3年吞咽困难病史的81岁男性接受了直径1厘米的食管远端肿物的内镜下切除术。检查发现一个黏膜下肿瘤，呈边界清楚的生长方式，由小管、囊肿和乳头组成，并伴有明显的间质淋巴样浸润。囊肿腔和乳头内衬2至6层细胞形态温和的立方形至柱状细胞，罕见核分裂象。细胞基底层平滑肌肌动蛋白呈均匀阳性。局灶可见黏蛋白阳性的胞质内小腔，但未见细胞质内黏蛋白。没有巴雷特化生上皮的证据。这些特征与之前报道的两例，可能还有三例食管腺瘤的特征相似，并且与涎腺导管乳头状瘤相似，后者是一种罕见的小唾液腺肿瘤。它们的临床病理和免疫组织学特征表明这些肿瘤起源于黏膜下腺导管。与之前报道的病例比较表明，尽管各种成分（小管、囊肿和乳头）的比例可能有所不同，但所有病例似乎都呈缓慢生长、临床惰性的病程，完全切除后无复发迹象。
