Seifert G, Donath K
Institute of Pathology, University of Hamburg, Germany.
Eur J Cancer B Oral Oncol. 1996 Jul;32B(4):251-9. doi: 10.1016/0964-1955(95)00059-3.
Hybrid tumours are very rare tumour entities which are composed of two different tumour entities, each of which conforms with an exactly defined tumour category. The tumour entities of a hybrid tumour are not separated but have an identical origin within the same topographical area. In contrast, biphasically differentiated tumours are a mixture of two cellular patterns with a corresponding term in the tumour classification. Examples of a biphasic differentiation are: basaloid-squamous carcinoma, adeno-squamous carcinoma or sarcomatoid carcinoma, and epithelial-myoepithelial carcinoma, mucoepidermoid carcinoma or adenoid cystic carcinoma. Hybrid tumours must also be distinguished from the multiple occurrence of salivary gland tumours which can develop syn- or metachronously. In the tissue samples of more than 6600 salivary gland tumours covered by the Salivary Gland Register (Institute of Pathology, University of Hamburg, Germany) only 5 cases of hybrid tumours were recorded between 1965 and 1994. This means less than 0.1% of all registered tumours. Case 1 was a very rare example of a hybrid adenoma with differentiation as a basal cell adenoma and a canalicular adenoma of the parotid gland. The similar cellular origin of both types of adenoma may be an explanation for its development in a hybrid adenoma. Case 2 is a hybrid tumour with a composition of basal cell adenoma and a glandular type of adenoid cystic carcinoma. In both types of tumours the two cell types (duct-lining cells and modified myoepithelial cells) have a similar histogenetic origin. Therefore, the development of the both cell types in a hybrid tumour with two trends of differentiation is possible. Case 3 represents a hybrid adenoma as a mixture of a Warthin tumour and a sebaceous adenoma. Although inclusions of sebaceous cells are observed in Warthin tumours, this hybrid tumour shows a composition of two different epithelial structures in a varied mixture. Case 4 is a very rare and unique hybrid carcinoma with two absolutely different components: acinic cell carcinoma and salivary duct carcinoma. The poor prognosis of this hybrid carcinoma is determined by the salivary duct carcinoma. Case 5 represents a hybrid carcinoma whose two components have a similar histogenetical basis: epithelial-myoepithelial carcinoma and a glandular type of adenoid cystic carcinoma. Both carcinomas are composed of variable proportions of ductlining cells and myoepithelial cells.
混合瘤是非常罕见的肿瘤实体，由两种不同的肿瘤实体组成，每种肿瘤实体都符合明确界定的肿瘤类别。混合瘤的肿瘤实体并非相互分离，而是在同一局部区域内具有相同的起源。相比之下，双相分化肿瘤是两种细胞模式的混合，在肿瘤分类中有相应的术语。双相分化的例子有：基底样鳞状癌、腺鳞癌或肉瘤样癌，以及上皮-肌上皮癌、黏液表皮样癌或腺样囊性癌。混合瘤还必须与可同时或异时发生的涎腺肿瘤的多发情况相区分。在德国汉堡大学病理研究所的涎腺登记册涵盖的6600多例涎腺肿瘤组织样本中，1965年至1994年间仅记录到5例混合瘤。这意味着在所有登记的肿瘤中占比不到0.1%。病例1是一例非常罕见的混合性腺瘤，分化为基底细胞腺瘤和腮腺管性腺瘤。两种腺瘤相似的细胞起源可能是其发展为混合性腺瘤的一个解释。病例2是一种由基底细胞腺瘤和腺样囊性癌腺型组成的混合瘤。在这两种肿瘤中，两种细胞类型（导管内衬细胞和改良肌上皮细胞）具有相似的组织发生起源。因此，在具有两种分化趋势的混合瘤中，两种细胞类型都有可能发展。病例3代表一种由沃辛瘤和皮脂腺腺瘤混合而成的混合性腺瘤。虽然在沃辛瘤中观察到皮脂腺细胞包涵体，但这种混合瘤显示出两种不同上皮结构的多样化混合组成。病例4是一种非常罕见且独特的混合癌，具有两个完全不同的成分：腺泡细胞癌和涎腺导管癌。这种混合癌的不良预后由涎腺导管癌决定。病例5代表一种混合癌，其两个成分具有相似的组织发生学基础：上皮-肌上皮癌和腺样囊性癌腺型。两种癌均由不同比例的导管内衬细胞和肌上皮细胞组成。
