左侧海绵窦转移性腮腺腺泡细胞癌一例报告并文献复习.pdfVIP

1014 . 中国现代神经疾病杂志2013 年 12 月第 13 卷第 12 期 Chin J Contemp Neurol Neurosurg , December 2013 , Vo l. 13, Noω12 ·临床病理报告· 左侧海绵窦转移性腮腺腺泡细胞癌: 一例报告并文献复习 林晓燕宋英华王家耀 [摘要1 目的 探讨左侧海绵窦转移性腮腺腺泡细胞癌的临床病理学特征。方法 报告1 例临床 罕见的左侧海绵窦转移性腮腺腺泡细胞癌患者的临床经过，分析其临床表现、病理学特点和鉴别诊断要 点，并复习相关文献。结果 女性患者，50 岁。临床表现为左眼视物模糊、阵发性头晕。 MRI 显示左侧 鞍旁海绵窦区占位性病变。术中可见左侧海绵窦上壁灰红色肿瘤组织，质地柔软，血供丰富。组织形态 学观察肿瘤组织由体积较大的细胞构成，胞质嗜酸性，呈片状、腺泡状或乳头状排列，胞核为圆形或卵圆 形，可见小核仁;免疫组织化学染色肿瘤细胞表达细胞角蛋白、上皮膜抗原、波形蛋白、5-100 蛋白，胶质 纤维酸性蛋白表达呈弱阳性，灶性表达P53 蛋白，Ki-67 抗原标记指数为5%ω 10lj毛，不表达神经内分泌和 垂体激素标志物。根据患者既往腮腺肿瘤切除术史，并对比腮腺肿瘤与海绵窦肿瘤的组织形态学及免 疫表型，最终明确诊断为海绵窦转移性腮腺腺泡细胞癌，随访21 个月无复发。结论 海绵窦转移性腮 腺腺泡细胞癌来自腮腺，1临床十分罕见，诊断过程中应详细了解病史，并注意与组织形态学及免疫表型 与之相重叠的乳头状型脑膜瘤、脉络丛乳头状肿瘤、乳头状型室管膜瘤、乳头状型胶质神经元肿瘤及脊 索瘤等相鉴别，以免误诊或漏诊3 [关键词1 癌，腺泡细胞; 腮腺; 肿瘤转移; 海绵窦; 免疫组织化学; 病理学 Acinic cell carcinoma of parotid gland metastasis to left cavernous sinus: a case report and review of literature LIN Xiao-yan , 50NG Ying-hu矿， WANG Jia-yao JDepαrtment of Pathology, Shandong Provincial Hospital 司ffiliαted to Shandong University, Jinan 250021 , Shαndong， Chinα Depαrtment of Respiratory Medicine , Qiαnfoshan Hospital 司ffiliated to Shandong University, Jinan 250014, Shαndong， China Corresponding αuthor: WANG Jiα-yαo (Email: wjybl@163.com) [Abstract) Objective To investigate the clinical manifestations and pathological features of parotid gland pap ilIary acinic ce Il carcinoma metastasis to left cavernous sinus. Methods The clinical manifestations , pathological features and differential diagnosis were studied in one case of parotid papi Ilary acinic ce Il carcinoma metastasis to left cavernous sinus. Related literatures were also reviewed. Results The patient was a 50-year-old female who presented paroxysmaI dizziness for 5 months and blurred vision in her left eye for 10 months. The MRI examinat