Moran C A
Department of Pulmonary and Mediastinal Pathology, Armed Forces Institute of Pathology, Washington, DC. 20306-6000, USA.
Semin Diagn Pathol. 1995 May;12(2):106-22.
Primary pulmonary neoplasms that bear similar histopathologic features to those seen in salivary glands are rare. Although their presence has been well documented in the literature, it has been primarily in the form of single case reports. Consequently, it has been difficult until recently to determine their prevalence, clinical behavior, treatment, and spectrum of histopathologic features. Moreover, because of the rarity with which these tumors occur, one needs to be familiar with their diverse histopathologic features to comfortably arrive at the correct diagnosis. Because of their close histological similarities to their salivary gland counterparts, careful clinical evaluation is necessary to establish the primary nature of these tumors in the lung and to rule out the possibility of a metastasis. Another feature that may generate difficulties in interpretation is that some of these tumors may share certain histopathologic and some immunohistochemical features with each other. This may pose a serious problem, particularly when dealing with small biopsy samples. Therefore, the use of special studies such as electron microscopy and routine histochemistry may be beneficial and must be used in addition to conventional microscopy and immunohistochemistry to corroborate the diagnosis. In essence, the diagnosis of these tumors requires a combined approach that must include a detailed clinical history, a reasonably sized sample for histopathologic evaluation, histochemical and immunohistochemical studies, and an ultrastructural examination.
具有与唾液腺肿瘤相似组织病理学特征的原发性肺肿瘤十分罕见。尽管文献中已对其存在有充分记载，但主要是以单病例报告的形式。因此，直到最近都很难确定它们的患病率、临床行为、治疗方法以及组织病理学特征谱。此外，由于这些肿瘤发病率低，需要熟悉其多样的组织病理学特征才能准确做出诊断。由于它们在组织学上与唾液腺肿瘤极为相似，因此需要进行仔细的临床评估，以确定这些肺部肿瘤的原发性质，并排除转移的可能性。另一个可能在解读上造成困难的特点是，其中一些肿瘤可能彼此具有某些共同的组织病理学和免疫组化特征。这可能会带来严重问题，尤其是在处理小活检样本时。因此，使用电子显微镜检查和常规组织化学等特殊研究可能会有所帮助，并且除了传统显微镜检查和免疫组化外，还必须使用这些方法来佐证诊断。本质上，这些肿瘤的诊断需要综合方法，必须包括详细的临床病史、用于组织病理学评估的合适大小样本、组织化学和免疫组化研究以及超微结构检查。
