Wassef M, Kanavaros P, Nemeth J, Adjamagbo H, Ba Huy P T
Service Central d'Anatomie et Cytologie Pathologiques, U.F.R. Lariboisière, Saint Louis, Hôpital Lariboisière, Paris.
Ann Pathol. 1993;13(3):170-5.
Middle ear adenoma is a rare benign tumor that exhibits a pleomorphic histological pattern, with solid, cribriform, tubular and trabecular features, which often lead to a diagnosis of a malignant tumor. We report a case of middle ear adenoma, displaying the typical amphicrine biphasic cell growth, better visualized by immunohistochemical and ultrastructural studies. These tumors are composed of two cell types, endocrine B cells containing neurosecretory granules and labelled with anti-keratin, anti-vimentin and anti-neuron specific enolase antibodies, and exocrine A cells containing mucous granules and immunoreactive with anti-keratin and anti-epithelial membrane antigen antibodies. These immunohistochemical and/or ultrastructural characteristics may be helpful to confirm the diagnosis of middle ear adenoma which should be treated by local excision without additional therapy. The essential identity of middle ear adenoma and so called carcinoid tumors of the middle ear is highlighted. We propose to name these tumors middle ear amphicrine adenoma which better reflects their benign and biphasic nature.
中耳腺瘤是一种罕见的良性肿瘤，具有多形性组织学模式，表现为实性、筛状、管状和小梁状特征，这常导致误诊为恶性肿瘤。我们报告一例中耳腺瘤病例，其显示出典型的双分泌双相细胞生长，通过免疫组织化学和超微结构研究能更好地观察到。这些肿瘤由两种细胞类型组成，内分泌B细胞含有神经分泌颗粒，并用抗角蛋白、抗波形蛋白和抗神经元特异性烯醇化酶抗体标记，外分泌A细胞含有黏液颗粒，与抗角蛋白和抗上皮膜抗原抗体发生免疫反应。这些免疫组织化学和/或超微结构特征可能有助于确诊中耳腺瘤，该病应采用局部切除治疗，无需额外治疗。强调了中耳腺瘤与所谓中耳类癌肿瘤的本质相同性。我们建议将这些肿瘤命名为中耳双分泌腺瘤，这能更好地反映其良性和双相性质。
