Michal M, Skálová A, Simpson R H, Rychterová V, Leivo I
Department of Pathology, Medical Faculty of Charles University, Pilsen, Czech Republic.
Histopathology. 1996 Apr;28(4):309-15. doi: 10.1046/j.1365-2559.1996.d01-439.x.
Previous reports of monomorphic clear cell carcinoma of the salivary glands have shown inconsistent results with immunohistochemistry, especially for S-100 protein, and this has led to uncertainty about the nature of these tumours. We believe that much can be explained by considering this group as comprising not one but two separate neoplasms, one epithelial and the other myoepithelial. The former has been described as hyalinizing clear cell carcinoma--it generally occurs in the minor salivary glands, and strongly expresses cytokeratins but not S-100 protein or alpha smooth muscle actin. In contrast, this study presents five primary malignant tumours of the major salivary glands also composed largely of a single population of clear cells, but displaying histological and immunohistochemical features of myoepithelial differentiation, such as the formation of collagenous spherules and expression of S-100 protein and actin. A small number of similar tumours have been reported previously. We, therefore, believe that these neoplasms represent a clear cell variant of malignant myoepithelioma (myoepithelial carcinoma).
先前关于涎腺单形性透明细胞癌的报道显示，免疫组化结果并不一致，尤其是S-100蛋白，这导致了对这些肿瘤性质的不确定性。我们认为，将这一组肿瘤视为由两种而非一种独立肿瘤组成（一种为上皮性肿瘤，另一种为肌上皮性肿瘤），很多问题就能得到解释。前者被描述为透明变性透明细胞癌，通常发生于小涎腺，强烈表达细胞角蛋白，但不表达S-100蛋白或α平滑肌肌动蛋白。相比之下，本研究呈现了5例主要涎腺原发性恶性肿瘤，其也主要由单一的透明细胞群体组成，但显示出肌上皮分化的组织学和免疫组化特征，如胶原小球的形成以及S-100蛋白和肌动蛋白的表达。先前已有少量类似肿瘤的报道。因此，我们认为这些肿瘤代表恶性肌上皮瘤（肌上皮癌）的透明细胞变体。
