Clinicopathological Features of Adenoid Cystic Carcinoma of the Upper Trachea
10.3969/j.issn.1674-9081.2015.01.006
- VernacularTitle:气管上段腺样囊性癌的临床病理
- Author:
Zhen HUO
1
;
Yun-Xiao MENG
;
Huan-Li DUAN
;
Jie SHEN
;
Yu-Feng LUO
;
Jin-Ling CAO
;
Shu-Ying ZHANG
;
Zhi-Yong LIANG
Author Information
1. 中国医学科学院 北京协和医学院 北京协和医院 1 病理科
- Keywords:
upper trachea;
adenoid cystic carcinoma;
immunohistochemistry;
differential diagnosis
- From:
Medical Journal of Peking Union Medical College Hospital
2015;(1):29-34
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinicopathological features and key points in diagnosis and dif -ferential diagnosis of adenoid cystic carcinoma of the upper trachea .Methods From January 2000 to February 2014 , 4 cases of adenoid cystic carcinoma of the upper trachea were diagnosed in Peking Union Medical College Hospital .Microscopic , immunohistochemical , and histochemical staining results of the patients were reviewed to summarize the clinicohistological and immunohistochemical features as well as key points of diagnosis and differ -ential diagnosis of adenoid cystic carcinoma of the upper trachea .Results The 4 patients of adenoid cystic carci-noma of the upper trachea included 1 male and 3 females, aged 38-57 years (mean age 47 years).None had history of adenoid cystic carcinoma , and one had the history of nodular goiter surgery .Microscopically , 4 cases all appeared as cribriform/tubular type, with thyroid tissue involvement in 3 cases, nervous tissue involvement in 3 cases, and no lymph node involvement .Immunohistochemically , P16, CD117, BCL-2, P63, SMA, and typeⅣ collagen were positive in all 4 patients , average Ki-67 index was 8%, and TTF-1 and P53 were negative in all patients .Histochemically , AB/PAS was positive in all patients .All the 4 cases received postoperative radiothera-py (total dose 48-56 Gy) and were followed up for 6-120 months (mean 72.5 months).One case had relapse after 96 months , and the other 3 had no recurrence or metastasis during the follow-up period .Conclusions Ad-enoid cystic carcinoma of the upper trachea is a rare low-grade malignant tumor .It is slow-growing and the major-ity of patients have invasion of thyroid tissue at presentation .It has to be differentiated from primary thyroid canc-er , especially in fine-needle aspiration cytology and intraoperative frozen section of the thyroid .Accurate diagno-sis can be made based on laryngotracheoscopical findings , typical morphological , immunohistochemical and histo-chemical features .Complete resection of the tumor is hard to achieve , therefore radiotherapy may be useful to prevent recurrence .
