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目的探讨涎腺硬化性多囊性腺病(SPA)的临床及病理形态特征、诊断和鉴别诊断。方法对1例SPA进行临床、组织学形态和免疫组化染色观察,并文献复习。结果 SPA临床主要表现为腮腺区缓慢生长的无痛性肿块。组织学结构与乳腺纤维囊性病相似,表现为不规则的导管及腺泡分布于丰富的硬化性胶原间质中,形成模糊的小叶结构;腺上皮细胞形态多样,局部导管上皮增生伴轻度非典型性。免疫组化显示腺上皮EMA弥漫强(+),c-erbB2中度(+),CEA、ER、PR局灶(+),CD68(-);导管及腺泡周围肌上皮连续SMA和S-100(+);Ki-67增殖指数<1%。结论硬化性多囊性腺病是一种具有独特病理形态学特征的罕见涎腺疾病,需要与慢性硬化性涎腺炎等其他涎腺病变鉴别。
Objective To investigate the clinical and pathological features, diagnosis and differential diagnosis of salivary sclerosing polycystic gland disease (SPA). Methods A case of SPA clinical, histological and immunohistochemical staining, and literature review. Results The main clinical manifestations of SPA are slowly growing parotid gland area painless mass. Histological structure and breast fibrocystic disease similar to the performance of irregular catheters and acinar distribution in the rich sclerotic collagen interstitial formation of fuzzy lobular structure; glandular epithelial cells in various forms, local catheter epithelial hyperplasia with mild SARS Type. Immunohistochemistry showed that there were diffusely strong (+), c-erbB2 (+), CEA, ER, PR, CD68 100 (+); Ki-67 proliferation index <1%. Conclusions Harmful polycystic gland disease is a rare salivary gland disease with unique pathomorphological features that needs to be distinguished from other salivary gland lesions such as chronic sclerosing sialadenitis.