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目的 原发性中耳类癌很少见 ,国内尚未见报道 ,现报告一例并结合文献复习进行讨论。方法 患者女性 ,48岁 ,右中耳肿瘤切除术后 19年复发 ,将活检标本作组织学 (HE染色 )、组织化学 (奥辛蓝、PAS、嗜银染色 )、免疫组化染色 (SP法 )检查。结果 组织学 ,前后两次活检肿瘤形态一致 ,主要由实体小梁状及腺管状两种结构组成 ,瘤细胞异形性小 ,未见核分裂 ,但可见肿瘤呈浸润性生长。组织化学 ,奥辛蓝 (AB)、过碘酸雪夫氏反应 (PAS)染色阴性 ,嗜银染色胞浆内可见嗜银颗粒。免疫组化 ,突触素 (Syn)、神经特异性烯醇化酶 (NSE)、细胞角蛋白 (CK )弥漫阳性 ,嗜铬蛋白(CgA)灶性阳性 ,溶菌酶 (Lyz)阴性。 结论 原发性中耳类癌复发 ,同时与中耳腺瘤和中耳副节瘤等肿瘤鉴别。
The purpose of primary middle ear carcinoid is rare, not yet reported in China, the report of a case and combined with the literature review for discussion. METHODS: Female, 48 years old and right middle ear tumor recurred 19 years after resection. The biopsy specimens were stained with HE staining, histochemistry (AO Xin blue, PAS, silver staining), immunohistochemistry )an examination. Results Histomorphology showed that the biopsies were consistent in morphology before and after the operation. The tumors were mainly composed of solid trabecular and glandular tubules. The abnormality of the tumor cells was small with no nuclear fission. However, the tumors showed invasive growth. Histochemistry, oxin blue (AB), periodic acid Schiff’s reaction (PAS) staining negative, silver staining of argyrophilic cytoplasm silver particles can be seen. Immunohistochemistry showed that synaptophysin (Syn), neuron specific enolase (NSE), cytokeratin (CK) were diffusely positive, CgA positive was foci, and Lyz was negative. Conclusions The primary middle ear carcinoid recurrence, at the same time with the diagnosis of middle ear adenoma and middle ear parathyroid tumor.