转移性腺样囊性癌15例临床病理分析OA

Objective To investigate the clinicopathological characteristics,diagnosis,and differential diagno-sis of metastatic adenoid cystic carcinoma(ACC).Methods The clinical data,histological features,immunohisto-chemical profiles,and MYB/NFIB gene fusion status of 15 metastatic ACC cases were retrospectively analyzed.Re-sults Among the 15 patients with metastatic ACC,7 were males and 8 were females,ranging in age from 27-71 years(mean:50.6 years).The metastatic sites included the lung,brain,liver,bone,and other organs.Imaging revealed single or multiple nodular shadows at the metastatic sites.Histologically,ACC was characterized by tubular,cribri-form,and solid patterns composed of ductal and myoepithelial cells.Immunohistochemically,the ductal cells were positive for CK7,CK19,and CD117,while the myoepithelial cells were positive for SMA,S-100,p63,and MYB.The median Ki67 proliferation index was 25％.FISH analysis showed MYB/NFIB gene fusion in 7 cases.Conclusion ACC has a high risk of distant metastasis,with the lung being the most common site,although metastases to the bone,liver,and brain may also occur.Due to its nonspecific presentation,metastatic ACC is prone to misdiagnosis.A com-bination of clinical history,histopathological evaluation,immunohistochemistry,and FISH testing can provide crucial diagnostic clues and improve diagnostic accuracy.