肺肌上皮肿瘤伴活跃的反应性肺细胞

Lisi Yuan, N. Katabi, C. Antonescu, A. Golden, W. Travis, N. Rekhtman
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引用次数: 6

摘要

肺细胞性腺肌上皮瘤(PAM)于2007年首次被描述,并作为上皮-肌上皮肿瘤的一种变体被列入2015年世界卫生组织肺肿瘤分类。据报道,这种罕见的肺肿瘤同时表现为肌上皮和导管样成分,后者表现为肺细胞分化并表达TTF-1。我们提出了一个索引病例和另外6例回顾性鉴定的肺肿瘤与PAM的原型特征。然而,根据额外的临床放射学、组织学、免疫组织化学和细胞遗传学数据,我们能够将其重新分类为肌上皮性肿瘤,包括原发性和转移性,并伴有被TTF-1+肺细胞包围的增生肺泡结构。我们回顾了有关PAM和肌上皮肿瘤的现有文献。我们的病例表明,被称为PAM的实体代表肌上皮肿瘤的间质生长,吸引被包裹的肺细胞显著增殖,而不是具有肺细胞分化的明显双相肿瘤。
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Pulmonary Myoepithelial Tumors With Exuberant Reactive Pneumocytes
Pneumocytic adenomyoepithelioma (PAM) was first described in 2007 and was included in the 2015 World Health Organization Classification of lung tumors as a variant of epithelial-myoepithelial tumor. This rare pulmonary neoplasm was reported to show both myoepithelial and duct-like components, with the latter exhibiting pneumocytic differentiation with TTF-1 expression. We present an index case and 6 additional retrospectively identified cases of pulmonary tumors with prototypical features of PAM. However, with additional clinicoradiologic, histologic, immunohistochemical and cytogenetic data, we were able to reclassify them as myoepithelial neoplasms—both primary and metastatic—with entrapped exuberantly hyperplastic alveolar structures lined by TTF-1+ pneumocytes. We reviewed the available literature related to PAM and myoepithelial tumors. Our cases suggest that the entity referred to as PAM represents interstitial growth of myoepithelial neoplasms enticing marked proliferation of entrapped pneumocytes rather than a distinct biphasic neoplasm with pneumocytic differentiation.
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