伴有广泛角化囊肿的多形性腺瘤1例

多形性腺瘤是唾液腺中最常见的良性肿瘤,其组织学形态是多样性的.约25％的多形性腺瘤可伴有鳞化,而伴有广泛鳞化及角化囊肿的病例极其罕见,需要与其他囊性病变、鳞状细胞癌、黏液表皮样癌等进行鉴别.本文报道了1例伴有广泛角化囊肿形成的罕见病例,鳞化及角化囊肿成分约占多形性腺瘤的40％.最终,通过文献复习,笔者总结了伴有广泛角化...     

涎腺多形性腺瘤恶变机制的研究进展

涎腺多形性腺瘤是最常见的涎腺上皮性肿瘤,多次复发或病程长者可恶变为恶性多形性腺瘤.涎腺多形性腺瘤的恶变是多因素、多基因变异的综合病变过程.研究发现,细胞遗传学改变、癌基因、抑癌基因、黏附分子及细胞外基质蛋白在涎腺多形性腺瘤的恶变过程中均有一定的作用.本文就多形性腺瘤恶变机制的研究进展作一综述.     

腮腺区复发性多形性腺瘤恶变侵犯颧骨1例报告

腮腺区复发性多形性腺瘤（recurrent pleomorphic adenoma,RPA）存在一定的恶变几率,但检索国内外文献未见侵犯颧骨的报道。本文报告1例腮腺区复发性多形性腺瘤恶变侵犯颧骨病例,并结合相关文献分析其临床、影像及病理特点,以进一步提高对该病的认识,减少误诊误治。     

颌下腺转移性多形性腺瘤1例

本文报道1例罕见的转移性多形性腺瘤,患者女性,30岁,左颌下腺及右锁骨上包块术后病检结果与患者8年前左颌下腺肿块切除后病检结果一致,病理形态均表现为良性多形性腺瘤。并结合文献报道,对转移性多形性腺瘤的临床病理特征、发病机制及防治方法等进行讨论。     

多形性腺瘤基因1与唾液腺肿瘤

近年来学者发现,多形性腺瘤基因1的激活和表达与多形性腺瘤及其他唾液液肿瘤的发生密切相关。多形性腺瘤基因1具有转录因子活性,通过对下游靶基因的表达调控而发挥生物学功能。对多形性腺瘤基因1及其相关基因的功能以及其在多形性腺瘤发病机制中的作用研究,在口腔颌面肿瘤领域具普遍指导意义。     

人腮腺多形性腺瘤细胞的体外培养

目的:建立人腮腺多形性腺瘤有限细胞系.方法:取腮腺多形性腺瘤患者原发肿瘤进行原代培养.观察细胞的形态特征,绘制细胞生长曲线,采用免疫细胞化学检测细胞内特异性抗原标志物,对细胞进行鉴定.结果:多形性腺瘤细胞体外培养时间约为80d,传代至16代,细胞呈短梭形、多边形,肿瘤性腺上皮细胞角蛋白弱阳性,肿瘤性肌上皮细胞肌动蛋白阳性、波形蛋白阳性.结论:多形性腺瘤细胞在体外培养连续传代,为永生化腮腺多形性腺瘤细胞系的建立奠定了基础.     

下颌下腺非侵袭性恶性多形性腺瘤1例报告

唾液腺非侵袭性恶性多形性腺瘤(Ca-ex-PA)又称发生在多形性腺瘤中的原位癌,是较少见的病理类型,临床表现与良性多形性腺瘤相似,有条件完整切除肿瘤,复发或转移少见,预后良好.本文报告1例下颌下腺非侵袭性多形性腺瘤的临床病理学特征,认为鉴别非侵袭性Ca-ex-PA和侵袭性Ca-ex-PA对判断预后十分重要,并影响治疗方案的选择,WHO对唾液腺多形性腺瘤恶变的分型在肿瘤的生物学行为和预后方面具有实际意义.     

腮腺多形性腺瘤178例临床分析

目的:探讨腮腺多形性腺瘤的临床特征和术后并发症的防治。方法:对178例经病理确诊为腮腺多形性腺瘤的患者进行临床回顾性分析。结果:手术后发生暂时性面瘫31例,味觉出汗综合征6例,涎瘘7例,积液2例,复发3例。结论:腮腺多形性腺瘤治疗以外科手术为主,应注意对并发症的防治。     

舌下腺癌在多形性腺瘤中1例

发生于舌下腺的癌在多形性腺瘤中极为罕见。本文报道 1例发生于舌下腺的腺样囊性癌在多形性腺瘤的病例。     

原发多灶性腮腺多形性腺瘤1例报告及文献复习

该文通过报道1例原发多灶性腮腺多形性腺瘤患者的临床资料,并进行文献复习。此例原发多灶性腮腺多形性腺瘤发现及时,在右侧腮腺中发现两个独立存在的多形性腺瘤,病理诊断明确,手术彻底,愈后良好。原发多灶性腮腺多形性腺瘤罕见,术前影像学检查、术中详细触诊和手术方式的选择具有重要意义。     

Myxolipomatous pleomorphic adenoma: an unusual oral presentation

The first case of a myxoid variant of lipomatous pleomorphic adenoma arising in the intraoral minor salivary gland is presented. A well-encapsulated tumor was composed almost entirely of myxolipomatous tissue with honeycomb-like spindled cellular areas, which contained only a scant glandular element. Immunohistochemistry confirmed the myoepithelial nature of spindle cells intimately admixed with mucoadipose component. We propose the term myxolipomatous pleomorphic adenoma for this peculiar lesion.     

Atypical lipomatous tumor of the lip with pleomorphic lipoma-like myxoid area, clinically simulating mucocele

Lipomatous tumor is least common in the oral cavity. We present a case of atypical lipomatous tumor arising in the lower lip of an 81-year-old male. Clinical diagnosis was mucocele. The tumor measured 12 mm in diameter with a round shape. It was solid, firm, myxomatous and translucent with a small yellowish focus in the central portion. Histologically, the tumor was a circumscribed and well-encapsulated mass with prominent myxoid matrix. The central minor portion showed a well-differentiated liposarcoma. In the myxoid area, lipoblasts and large atypical cells with dense chromatin including floret-like giant cells were seen in abundance. Atypical lipomatous tumor may be indistinguishable from pleomorphic lipoma and its distinction from the latter is based on location as well as relative abundance of floret-type giant cells and lipoblasts. According to its abundance in lipoblasts over floret-like cells, pleomorphic lipoma-like area in our case could also be a part of atypical lipomatous tumor. It may be possible to interpret myxoid change in our case as to represent a superficial counterpart of myxoid malignant fibrous histiocytoma-like change reported in the retroperitoneal lesion.     

MMP-9和VEGF在腮腺多形性腺瘤中的表达研究

目的 研究MMP-9和VEGF在腮腺多形性腺瘤中的表达情况及其与肿瘤良恶性的关系。方法 应用荧光实时定量PCR和Western blotting方法检测32对多形性腺瘤及其瘤旁组织中MMP-9和VEGF的表达。结果 32例多形性腺瘤中26例为良性,6例为恶性。MMP-9和VEGF的mRNA和蛋白表达量在多形性腺瘤组织中高于瘤旁组织（P＜0.05）;在恶性多形性腺瘤组织中高于良性多形性腺瘤组织（P＜0.05）。结论 MMP-9和VEGF在腮腺多形性腺瘤中高表达,并且可能与腮腺多形性腺瘤的恶变相关;腮腺多形性腺瘤肿瘤外1 cm为安全切除界限。     

Palatal pleomorphic adenoma with florid squamous metaplasia: a potential diagnostic pitfall

We report a case of pleomorphic adenoma with extensive squamous metaplasia in the palate of a 52-year-old Chinese man. The dimensions of the tumor were 15x13x13 mm. More than 95% of the epithelial element in the tumor was composed of sheets of squamous cells with cyst formation. The pathogenesis, potential diagnostic pitfalls, proliferative activity and cytokeratin expression of this tumor are discussed.     

A ciliated cyst as a component of pleomorphic adenoma of the parotid gland

A large cyst, lined with ciliated cells (ciliated cyst), was found as a component of a pleomorphic adenoma of the left parotid gland in a 34-year-old Japanese man. The dimensions of the tumor were 25 × 33 mm and it consisted of a solid mass with a centrally located cyst 20 × 23 mm. which contained yellowish-brown material of muddy consistency. The tumor was encapsulated and the solid mass had features typical of a pleomorphic adenoma. The inner surface of the cyst was lined with ciliated cells and scattered mucus-secreting cells in addition to cuboidal-to-flattened cells. In some regions, the neoplastic cells of the pleomorphic adenoma were exposed to the cavity of the cyst. A histological transformation from ciliated cells to pleomorphic adenomatous cells was also observed. These findings indicated that the ciliated epithelium was an element of the tumor. This is the first report, to our knowledge, of a ciliated cyst derived from some elements of a pleomorphic adenoma of the salivary gland.     

细胞表面糖蛋白表达异常与涎腺多形性腺瘤复发的关系

目的　研究多形上皮粘蛋白1(mucin 1)和E-钙粘蛋白(E-cd)与涎腺多形性腺瘤复发的关系,探讨可预测 涎腺多形性腺瘤复发的指标。方法　以52例涎腺多形性腺瘤石蜡标本为研究对象,其中初发33例,复发12例,恶 性7例。采用显微镜观察肿瘤周围包膜的状况,免疫组织化学检测初发、复发、恶性多形性腺瘤细胞的mucin 1和 E-cd蛋白表达情况。结果　初发和复发多形性腺瘤的包膜状况差异无显著性(P>0·05)。初发多形性腺瘤细胞的 mucin 1蛋白表达阳性率(64%)与复发者(67%)的差异无显著性(P>0·05)。两者的差别表现为mucin 1阳性表达 部位分布不同,初发者主要为细胞顶膜染色(19/21),复发者主要为整个细胞膜染色(6/8),两者差异有显著性(P< 0·05);恶性多形性腺瘤染色部位与复发者相同,且阳性表达率显著升高。3种肿瘤的E-cd表达阳性率差异无显著 性(P>0·05)。结论　多形性腺瘤的包膜状况在预测其复发潜能上实际应用性不强,多形性腺瘤细胞E-cd的表达 改变与其复发潜能无显著关系。Mucin 1在多形性腺瘤细胞膜上的异常分布,使其倾向于向周围分散生长,这种异 常分布可作为预测多形性腺瘤复发的指标之一。     

Immunohistochemical localization of members of the transforming growth factor (TGF)-β superfamily in normal human salivary glands and pleomorphic adenomas

Although pleomorphic adenoma is the most common type of salivary gland epithelial tumor, it frequently contains "mesenchymal"-like components, including myxoid or chondroid tissues. We reported previously that chondroid tissue formation in pleomorphic adenoma was associated with overexpression of bone morphogenetic proteins (BMPs) by neoplastic myoepithelial cells. BMPs belong to the transforming growth factor (TGF)-beta superfamily, so we hypothesized that pleomorphic adenoma may express TGF-betas and that these molecules may regulate mesenchymal-like tissue formation. To evaluate this hypothesis, we immunohistochemically examined TGF-beta1, -beta2 and -beta3 expression and localization in normal salivary glands and in 43 cases of pleomorphic adenomas. There was no evidence of TGF-beta1 expression in normal salivary glands or pleomorphic adenomas. Signals for TGF-beta2 in the normal salivary glands were observed in the intercalated ducts, while in pleomorphic adenomas they were observed in the inner ductal cells of the tubulo-glandular structures. Signals for TGF-beta3 in the normal salivary glands were observed in mucous cells, whereas in pleomorphic adenomas they were observed in the solid nests of neoplastic myoepithelial cells, in the portion showing squamous metaplasia, and in the inner ductal cells of tubulo-glandular structures. TGF-betas induce ectopic cartilage formation in vivo, but chondroid tissues in pleomorphic adenomas showed only weak TGF-beta3 expression. TGF-beta may be related to differentiation of the inner ductal cells and the neoplastic myoepithelial cells. In conclusion, pleomorphic adenomas expressed TGF-beta2 and -beta3, which may be associated with differentiation of the inner ductal cells and neoplastic myoepithelial cells.     

腮腺多形性腺瘤腺体切除范围的病理依据

目的　为腮腺多形性腺瘤腺体切除范围提供病理学依据。方法　通过显微镜对25例原发腮腺多形性腺瘤连续病理切片的观察,尤其是重点观察和测量腺瘤包膜外浸润、出芽生长情况,并探讨有无原发多中心分布。结果　①包膜外浸润及出芽生长的具体扩展范围为:0·09~0·29 mm,远小于腺体部分切除的安全边界(5~10 mm)。②原发多中心分布2例,但具有分散程度小、有统一融合包膜的特点。结论　腮腺多形性腺瘤瘤体外5~10 mm的腺体部分切除,可以达到根治的效果。