Fukunaga M, Endo Y, Ishikawa E, Ushigome S
Department of Pathology, Jikei University School of Medicine, Tokyo, Japan.
Histopathology. 1996 May;28(5):457-61. doi: 10.1046/j.1365-2559.1996.331373.x.
A 33-year-old Japanese woman presented with a polypoid 2.5 x 2.5 x 1.9 cm mass located in the posterior wall of the lower vagina. Microscopically, the tumour was composed of benign epithelial and stromal-type elements. Predominant epithelial elements were mucinous glands with squamous metaplasia and islands of mature squamous epithelium. The stromal-type cells showed reticular or short fascicular patterns with a transition to the epithelial elements. There was no dual epithelial-myoepithelial combination in the glands as seen in so-called mixed tumours (pleomorphic adenomas) of the salivary gland. Immunohistochemically, the epithelial elements were strongly positive for cytokeratin, PKK1 and epithelial membrane antigen, while the stromal-type cells co-expressed PKK1 and vimentin. Staining for S-100 protein, muscle actin, alpha-smooth muscle actin, desmin, and CD34 was uniformly negative in the tumour cells. The DNA pattern was diploid. The patient is alive and well without recurrence for 50 months after excision. These results indicate that an epithelial cell proliferation, probably of the remnant vestibular gland, plays a major role in the development of mixed tumours of the vagina.
一名33岁的日本女性患者，其阴道下段后壁有一个息肉样肿物，大小为2.5×2.5×1.9厘米。显微镜下，肿瘤由良性上皮和间质型成分组成。主要的上皮成分是伴有鳞状化生的黏液腺和成熟鳞状上皮岛。间质型细胞呈网状或短束状排列，并与上皮成分移行。腺体中未见唾液腺所谓混合瘤（多形性腺瘤）中所见的双上皮-肌上皮组合。免疫组化显示，上皮成分细胞角蛋白、PKK1和上皮膜抗原呈强阳性，而间质型细胞共表达PKK1和波形蛋白。肿瘤细胞中S-100蛋白、肌动蛋白、α-平滑肌肌动蛋白、结蛋白和CD34染色均为阴性。DNA模式为二倍体。患者切除术后50个月存活良好，无复发。这些结果表明，上皮细胞增殖，可能来自残留的前庭腺，在阴道混合瘤的发生中起主要作用。
