具有黏液和神经内分泌分化的肺癌 双向分化癌谱系扩展

免疫组化抗体神器

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  双向分化癌是一种特殊类型的癌,以同种肿瘤细胞同时出现外分泌和内分泌为特征。这种肿瘤非常罕见,胃肠道是最常见的好发部位,肺少有报道。本文报道3例这类肿瘤,扩展了肺双向分化癌的谱系。3例病例均为男性,年龄为53~78岁(平均:63岁),均为吸烟者或有吸烟史。其中1例为偶然发现,另2例均有下呼吸道症状。镜下肿瘤呈器官样结构,细胞巢周边呈栅栏状,细胞体积大,胞核呈泡状,核仁明显,形似大细胞神经内分泌癌。此外,瘤细胞巢呈腺样结构,腺样腔隙内充满黏液,同时肿瘤细胞胞质内亦见黏液空泡。免疫组化显示突触素和嗜铬素弥漫阳性,TTF-1反应不一。黏液染色示细胞外和细胞内黏液沉积。临床随访发现,其中1例术后12个月死于该病;另1例术后21个月无病存活。第3例存活,但在确诊后8个月出现广泛转移。本文报道的病例为罕见的肺癌类型,表现为同时出现外分泌和内分泌分化。认识该类肿瘤对肿瘤分类和确定潜在的侵袭性行为非常重要。
Am J Surg Pathol 2018;42:1246-1252
美国外科www.yabo51.com学杂志中文版2019年第二期摘要NO.6
(孙 琦 翻译? 刘 斌 审校)
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