摘要
目的 了解涎腺良、恶性淋巴上皮病变的临床病理特征及其与EB病毒的关系。方法 采用光镜、免疫组化染色、原位杂交、聚合酶链反应(PCR),对14例涎腺恶性淋巴上皮病变(MLEL)和5例涎腺良性淋巴上皮病变(BLEL)进行观察,同时复习临床相关资料,并进行随访。结果 涎腺MLEL好发于腮腺、颌下腺,以女性为主,平均年龄47岁。组织学:大量增生的淋巴组织中见成簇或条索状分布的肿瘤细胞,瘤细胞界限不清,呈合体状,胞质嗜酸或淡染,核呈空泡状,核仁大而明显,核分裂象多见。免疫组化:瘤细胞表达CK;EBV阳性检出率92.9％,BLEL仅1例阳性。原位杂交:4例MLEL检出EBV EBERs;2例BLEL均为阴性。PCR:4例MLEL检出EBV/IR3,1例BLEL未检出。结论 涎腺MLEL是一类较少见、好发于腮腺、女性多见的未分化癌,组织学类似于鼻咽部的淋巴上皮癌。肿瘤的发生与EBV感染密切相关。
Objective To study clinicopathological characteristics of benign lymphoepithelial lesion (BLEL), and malignant lym-phoepithelial lesion (MLEL) of salivary glands and their relationship with Epstein-Barr virus (EBV). Methods 14 cases of MLEL and 5 cases of BLEL were detected by microscopy, immunohistochemical technique (EnVision and SP methods), in situ hybridization and polymeras chain reaction (PCR). Results Salivary MLEL was likely to occur in parotid gland, submandibular gland, and mainly female with, mean age of 47.14 years. Histopathologically, the infiltrative tumor grew in diffuse sheets, nests or cords, separated by desmoplastic stroma. The tumor was characteristically densely infiltrated by lymphocytes and plasma cells. The tumor cells were typically large and had indistinct border. They possessed eosinophilic cytoplasm, vesicular nuclei and prominent nucleoli. Mitoses were commonly seen. Immunohistocheniical staining showed that tumor cells expressed CK(Low MW)and CK(High MW), EBV positive rate was 92.9%. Only 1 case of BLEL was EBV positive. In situ hybridization showed that all of 4 cases of MLEL were EBV EBERs positive, and both 2 cases of BLEL were EBV EBERs negative. EBV/IR3 was detected in all of 4 cases of MLEL, and none of EBV/IR3 was detected in 1 case of BLEL. Conclusion Salivary MLEL is a kind of undifferentiated carcinoma, which is rare and, likely to occur in parotid gland and mainly female. Its pathohistological characteristic is similar to lymphoepithelial-like carcinoma of nasopharyngx. EBV infection has closed relationship with the pathogenesis of MLEL.
出处
《诊断病理学杂志》
CSCD
2004年第3期144-147,i004,共5页
Chinese Journal of Diagnostic Pathology
关键词
涎腺良
恶性淋巴上皮病变
临床病理特征
EB病毒
免疫组化
原位杂交
涎腺肿瘤
Salivary gland tumor
Lymphoepithelial lesion
Undifferentiated carcinoma
Epstein-Barr virus
Immunohistoche-mistry
In situ hybridization
PCR
