van Krieken J H
Department of Pathology, University Hospital Leiden, The Netherlands.
Am J Surg Pathol. 1993 Apr;17(4):410-4. doi: 10.1097/00000478-199304000-00012.
A 66-year-old man presented with a mass just behind the lower part of the left ear. A biopsy showed a moderately differentiated adenocarcinoma that was prostate-specific antigen (PSA)- and prostate-specific acid phosphatase (PSAP)-positive. This finding suggested a metastasis of a prostatic carcinoma. Extensive clinical and radiographical examination revealed no primary prostatic carcinoma or other metastases and serum levels of PSAP and PSA were not elevated. The reliability of the PSA and PSAP staining was studied in a series of 25 adenocarcinomas of various primary sites in females and in 26 salivary gland tumors in both males and females, because a primary adenocarcinoma of salivary gland seemed another possibility in this case. As expected, there was no immunoreactivity for PSA and PSAP in the adenocarcinomas from females, but 6 of 11 pleomorphic adenomas, 0 of 4 monomorphic adenomas, 1 of 6 mucoepidermoid carcinomas, and 1 of 2 adenocarcinomas not otherwise specified (NOS) of the salivary gland showed at least focal staining of both PSA and PSAP. The conclusion was that the patient had a primary salivary gland adenocarcinoma NOS. In males with PSA- and PSAP-positive adenocarcinoma without signs of primary prostatic carcinoma, a salivary gland origin should be considered.
一名66岁男性因左耳下部后方出现肿物前来就诊。活检显示为中度分化腺癌，前列腺特异性抗原（PSA）和前列腺特异性酸性磷酸酶（PSAP）呈阳性。这一发现提示为前列腺癌转移。广泛的临床和影像学检查未发现原发性前列腺癌或其他转移灶，且PSAP和PSA的血清水平未升高。对25例女性不同原发部位的腺癌以及26例男性和女性的涎腺肿瘤进行了PSA和PSAP染色可靠性研究，因为涎腺原发性腺癌在该病例中似乎是另一种可能。正如预期的那样，女性腺癌中PSA和PSAP无免疫反应性，但涎腺的11例多形性腺瘤中有6例、4例单形性腺瘤中0例、6例黏液表皮样癌中1例以及2例未另行特指（NOS）的腺癌中有1例至少PSA和PSAP均有局灶性染色。结论是该患者患有原发性涎腺腺癌NOS。对于PSA和PSAP阳性腺癌且无原发性前列腺癌体征的男性，应考虑涎腺来源。
