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患者、男、61岁,左侧颌下腺无症状结节6周,近来疑增大,无局部或者全身症状(包括泌尿系统症状)。用抗菌素治疗无效,切除病变腺体后,做泌尿系统X 线检查,确诊为左侧肾癌。于第一次手术后的两个月作左肾切除。左侧颌下腺的大小为5.5(?)4.0 1.0cm,内含直径0.9cm 界限清楚的棕色小结。余留腺体无异常。镜下:该小结由巢状和片状分布的多角形细胞组成,中心是圆形胞核,有丰富的透明细胞质。胞核表现一定程度的异型性,未看见高度不典型细胞特征。PAS染色,作或未作淀粉酶消化,发现胞内有丰富的糖原。用粘液洋红和阿辛兰染色,显示缺乏粘蛋白和酸性粘多糖。癌巢之间由微纤维血管基质分界。病变呈灶性穿过完整结缔
The patient, male, 61 years old, with asymptomatic nodules in the left submandibular gland for 6 weeks, has recently been suspected of having increased, with no local or systemic symptoms (including urinary system symptoms). The treatment with antibiotics was ineffective. After removing the diseased glands, X-ray examination of the urinary system was performed. The diagnosis was left kidney cancer. Left kidney resection was performed two months after the first operation. The size of the left submandibular gland was 5.5 (?) 4.0 1.0 cm and contained a well-defined brown nodule with a diameter of 0.9 cm. There are no abnormalities in the remaining glands. Microscopically: The nodule is composed of nested and platy polygonal cells with a circular nucleus and abundant clear cytoplasm. The nuclei showed a certain degree of atypicality and no high atypical cell characteristics were seen. PAS staining, with or without amylase digestion, showed abundant intracellular glycogen. Staining with Magenta and Alcian Blue showed lack of mucin and acid mucopolysaccharides. The cancer nests are demarcated by microfibrovascular stroma. Lesions pass through the intact connective