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首页> 外文期刊>Ocular oncology and pathology. >Adenocarcinoma, Not Otherwise Specified, Arising in Accessory Lacrimal Gland: A Diagnostic Challenge
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Adenocarcinoma, Not Otherwise Specified, Arising in Accessory Lacrimal Gland: A Diagnostic Challenge

机译：在附属泪腺中产生的腺癌，未另行指明：诊断挑战

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Neoplasms arising in accessory lacrimal glands are rare. We describe a 33-year-old man with adenocarcinoma arising in the left lower eyelid accessory lacrimal gland. Microscopic evaluation demonstrated an infiltrative neoplasm composed of mildly to moderately pleomorphic cells with abundant eosinophilic cytoplasm and focal intracytoplasmic vacuoles, arranged predominantly in ductules. Foci of lumi-nal and intracytoplasmic eosinophilic secretory material and occasional mucin were noted. An in situ component was identified in the gland of Wolfring. Though perineural invasion was present, high-grade nuclear features, brisk mi-totic activity, and comedonecrosis were not identified. Im-munohistochemical studies were notable for immunoreac-tivity of the tumor cells for CK7, carcinoembryonic antigen, BRST-2, androgen receptors, and HER2/neu (2+). The neoplastic cells were negative for CK20, estrogen and progesterone receptors, S-100, p63, calponin, thyroid transcription factor-1, and prostate-specific antigen. Fluorescence in situ hybridization studies for ETV6 and MAML2 rearrangements and for HER2/neu amplification were negative. Because of the absence of unifying morphologic, immunophenotypic, and molecular genetic findings, the diagnosis of adenocarcinoma, not otherwise specified, was rendered. The patient underwent comprehensive oncologic workup, which was negative for another primary tumor and metastases. He remains disease free with a follow-up of 4 years. This case illustrates the challenges encountered in applying salivary gland tumor classification to the accessory lacrimal gland neoplasm.
机译：在辅助泪腺中产生的肿瘤很少见。我们描述了一名33岁的男子，左下眼睑配件泪腺产生腺癌。微观评估证明了一种渗透肿瘤，其渗透肿瘤与具有丰富的嗜酸性细胞质和局灶性嗜型细胞质和局灶性卵胞质泡沫塑料，主要在导管中排列。注意到Lumi-NAL和氏菌嗜酸性嗜酸性分泌物和偶尔粘蛋白的焦点。在WolFring的腺体中鉴定出原位组分。虽然存在危害侵袭，但没有识别出高档的核特征，轻盈的MI-Totic活性和复杂的坏死。 IM-Munohistochemical的研究对于CK7，癌胚抗原，BRST-2，雄激素受体和HER2 / NEU（2+）的肿瘤细胞的免疫凝固性研究非常显着。肿瘤细胞对于CK20，雌激素和孕酮受体，S-100，P63，Calponin，甲状腺转录因子-1和前列腺特异性抗原的阴性。 ETV6和MAML2重排和HER2 / Neu扩增的原位杂交研究的荧光为阴性。由于没有统一形态学，免疫蛋白酶和分子遗传结果，呈现腺癌的诊断，没有另外规定。患者接受了综合的肿瘤疗法，这对于另一个原发性肿瘤和转移是阴性的。他仍然没有4年的随访疾病。这种情况说明了将唾液腺肿瘤分类应用于辅助泪腺肿瘤肿瘤肿瘤遇到的挑战。

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