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带有伪腺体模式的myxoid adrenocortical腺瘤:对一种罕见的组织学变异及其诊断挑战的临床病理学研究
Runlin Feng1, Tao Zhang2, Changxing Ke2
1Department of Pathology, The Second Affiliated Hospital of Kunming Medical University, Kunming 650101, Yunnan, China.
Annals of diagnostic pathology
|July 10, 2025
概括
带有伪腺体模式的myxoid adrenocortical adenoma (MAA) 是一种罕见的良性上腺瘤. 这项研究澄清了其诊断特征,显示了有利的预后,并有助于将其与恶性瘤区分开来.
科学领域:
- 内分泌学 在内分泌学.
- 手术病理学手术病理学
- 在瘤学瘤学.
背景情况:
- 具有伪腺体模式的myxoid adrenocortical adenoma (MAA) 是一种罕见的上腺皮层瘤变体.
- 它独特的myxoid矩阵和建筑模式可以模仿恶性或转移性myxoid瘤,这给诊断带来了挑战.
研究的目的:
- 确定MAA的临床病理学,免疫组织化学和差异诊断特征.
- 为准确诊断提供洞察力,并防止恶性瘤的错误分类.
主要方法:
- 九个MAA病例 (2015-2023) 的回顾性分析.
- 包括临床放射学,遗传病学 (韦斯评分,网球蛋白) 和免疫表型数据.
- 免疫组织化学小组:α-inhibin,Melan-A,Synaptophysin,CD56,CK,Vimentin,S100,HMB45;通过Alcian蓝和AB-PAS进行粘素评估.
主要成果:
- 九例病例 (5名女性,4名男性;中位数年龄40岁) 瘤大小在2.2至7.4厘米之间.
- 组织学显示了丰富的myxoid stroma (78.3%),伪腺体/绳状/状结构,最小的异型,和低的线粒活动.
- 免疫组织化学检测显示扩散的α-inhibin (100%),Melan-A (88.9%),CD56 (77.8%),Synaptophysin (66.7%),Vimentin (100%);对S100,HMB45,Chromogranin A. Ki-67 <3%是负面的. 77.8%的蓝阳性,77.8%的蓝阳性
结论:
- 伪腺模式的MAA是一种良性瘤,由于与恶性瘤重叠,具有诊断挑战.
- 特征性形态,免疫特征和良性临床过程对于准确的诊断至关重要.
- 使用韦斯标准,网球蛋白染色和状瘤面板可以提高诊断准确度,防止过度治疗.
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