摘要
目的 探讨原发性肺淋巴上皮癌的临床病理特点.方法 回顾性分析海南医学院第一附属医院2016-06-2022-10期间诊断的病例7例,分析其临床特征,组织学形态,免疫表型及分子检测结果.结果 男性患者1例,女性6例,患者年龄33～63岁(平均49岁,中位年龄50岁),2例为肺门型,4例为周围型肿块.镜下所见,所有病例肿瘤细胞呈巢状或弥漫散在排列,胞质淡染或嗜酸,细胞核圆或椭圆形,染色质较细呈空泡状,部分肿瘤细胞呈合胞体样,有较显著的嗜酸性核仁,癌巢内及癌巢之间有多少不等的淋巴细胞及浆细胞浸润.免疫组化检测显示所有肿瘤细胞均表达panCK+,5例CK5/6+、p40+and p63(70％),不表达CK7、TTF-1、NapsinA,Ki-67增殖指数介于20％～80％,原位杂交分子检测显示所有病例EBER均为阳性.结论 原发性肺淋巴上皮癌好发于中年人群,病理形态上与多种肿瘤具有重叠的表现,易于误诊,EBER检测有利于提高本病的诊断率.
Abstract
Objective To investigate the clinicopathological features of primary lymphoepithelial carcinoma of lungs(PLECL).Methods The clinicopathology profiles of 7 cases of PLECL diagnosed from June 2016 to October 2022 in Department of Pathology,the First Affiliated Hospital of Hainan Medical University were reviewed and analyzed.Results There were 1 male and 6 females,with the age at presentation ranging from 33 to 63 years(mean 49 years;median 50 years).Five patients presented with a mass on the outer fields of the lungs on X-ray,two patients presented with a central mass.Microscopically,tumor cells arranged in nests or scattered in a diffused pattern with pale or eosinophilic cytoplasm and may have syncytial features with ill-defined cytoplasmic borders.The nuclei can be round,oval,or elongated,and have vesicular or finely granular chromatin with a distinct eosinophilic nucleolus.Stromal lymphocytes and plasma cells infiltrated were obvious.All tumor showed strong and diffuse immunohistochemical staining of CK pan,frequently expression of CK5/6,p63 and p40(5 of 7,respectively),but were negative for CK7,TTF-1,NapsinA.Ki-67 index ranged from 20％-80％.All tumors showed viral particle by in situ hybridization for Epstein-Barr virus-encoded small RNA.Conclusion PLECL tends to occur among the middle-aged and can be misdiagnosed as other carcinoma due to the overlap among them.EBER detection is helpful for diagnosis
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