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[唾液腺鳞状上皮癌的鉴别诊断]

[Differential diagnosis of squamous epithelial carcinoma of the salivary glands].

作者信息

Seifert G, Donath K

机构信息

Institut für Pathologie der Universität, Hamburg.

出版信息

Pathologe. 1998 May;19(3):201-8. doi: 10.1007/s002920050274.

Abstract

Primary squamous cell carcinomas (SCC) of the salivary glands are localized predominantly in the major salivary glands and must be distinguished from metastases of extraglandular SCC of the skin, especially the head and neck area. Squamous cell metaplasia in non-tumourous diseases of the salivary gland (e.g. necrotizing sialometaplasia) as well as in benign or malignant salivary gland tumours (e.g. metaplastic Warthin tumour) can simulate SCC. Other differential diagnostic problems are the structural variants of SCC which develop predominantly in the minor salivary glands, but not in the major salivary glands. Special types include the very rare adenoid SCC with pseudoglandular structures as the result of acantholysis, the biphasic adenosquamous carcinoma with differentiation as SCC and adenocarcinoma, the biphasic basaloid squamous carcinoma with a structure as SCC and solid basaloid carcinoma (analogous to the solid type of adenoid-cystic carcinoma) and the poorly differentiated mucoepidermoid carcinoma (grade III) with biphasic structure of undifferentiated epidermoid and intermediate cells as well as inclusion of small groups of mucous-producing goblet cells. The differential diagnostic criteria are analysed concerning prognosis and treatment.

摘要

涎腺原发性鳞状细胞癌(SCC)主要局限于大涎腺,必须与皮肤腺外SCC的转移灶相鉴别,尤其是头颈部区域的转移灶。涎腺非肿瘤性疾病(如坏死性涎腺化生)以及良性或恶性涎腺肿瘤(如化生型沃辛瘤)中的鳞状上皮化生可类似SCC。其他鉴别诊断问题是SCC的结构变异型,其主要发生于小涎腺,而非大涎腺。特殊类型包括极罕见的因棘层松解形成假腺管结构的腺样SCC、具有SCC和腺癌分化的双相性腺鳞癌、具有SCC结构和实性基底样癌结构(类似于腺样囊性癌的实性型)的双相性基底样鳞状癌以及具有未分化表皮样和中间细胞双相结构并包含少量产黏液杯状细胞的低分化黏液表皮样癌(III级)。对这些鉴别诊断标准进行了关于预后和治疗方面的分析。

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