Purpose To investigate the clinicopathological features, diagnosis , differential diagnosis , therapy and prognosis of salivary duct carcinoma( SDC ). Methods The clinical, pathologic and immunohistochemical features were evaluated in five cases of salivary duct carcinoma retrospectively. Results ( 1 )This neoplasm was usually occurred in parotid gland and had a definite predilection for older male patients with mean age of 64. 6 years, and the growth of the tumor was usually rather rapid. It was easy to involve peripheralnerves and to metastasize.( 2 )Salivary duct carcinoma was intraductal nests of dysplastic duct cells that grow in papillary,crihriform and solid configurations. Comedo-type. necrosis of the tumor nests was a distinctive feature. In addition. infiltrative growth was usually evident. ( 3 )Immunohistochemistry staining for CK, EMA, CEA ,GCDFP-15 , c-erbB-2 and p53 were positive expression in most tumor cells and Ki-67 presented a high level proliferation index. The positive expressions of ER.PR were sporadic in some cases. hut PSA,CD117 , p63 , S-100 . CDIO and GFAP were all negative expression. ( 4 )Follow-up data suggested that salivary duct carcinoma had a bad prognosis. Three of the five patients with salivary duct carcinoma had recurrence and one of them had metastasis. Conclusions SDC is a high-grade malignant carcinoma among all salivary carcinoma, histopathological changes of salivary duct carcinoma have re vealed a variety of similarities to ductal carcinomas in breast. The diagnosis for salivary duct carcinoma depends mainly on the pathological morphology and immunohistochemical expression, and needs to be differentiated from other tumors such as low-grade cribriform cys-tadenocarcinoma, mucoepidermoid carcinoma. solid adenoid cystic carcinoma, acinic cell carcinoma, papillary cystadenocarcmoma,polymorphous low-grade adenocarcmoma and epithelio-myoepithelial carcinoma.%目的 探讨涎腺导管癌(salivary duct carcinoma,SDC)的临床病理特征、诊断和鉴别诊断、治疗及其预后.方法 回顾性分析5例 SDC 的临床资料、病理学形态和免疫组织化学标记结果.结果 (1)SDC好发于老年男性,平均发病年龄64.6岁,主要见于腮腺,生长迅速,易侵犯神经,常发生转移.(2)组织学特点与乳腺导管癌极为相似.肿瘤细胞向导管内生长,形成乳头状、筛孔状、实性等多种结构,并可形成粉刺样坏死,肿瘤向周围组织浸润生长是其显著特征.(3)免疫组化结果显示肿瘤细胞CK、EMA、CEA、GCDFP-15、c-erbB-2、p53均阳性,Ki-67增殖指数较高,ER、PR在部分病例呈散在阳性表达,而PSA、CD117、p63、S-100、CD10、GFAP均阴性.(4)随访资料显示SDC具有较差的预后.该组5例中,3例复发,1例转移.结论 SDC是一种高度恶性的涎腺肿瘤,组织形态类似乳腺导管癌.对该肿瘤确诊主要依赖于病理形态特征与免疫组化结果相结合,且需要和其他肿瘤如低度恶性筛状囊腺癌、黏液表皮样癌、实性腺样囊性癌、腺泡细胞癌、乳头状囊腺癌、多形性低度恶性腺癌、上皮-肌上皮癌等鉴别.
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