细支气管腺瘤2例报道

2 Cases Report of Bronchiolar Adenoma

摘要: 细支气管腺瘤(bronchiolar adenoma, BA)是WHO (2021)胸部肿瘤中新定义的一种临床表现惰性的较为少见的实体肺肿瘤，且易与黏液腺癌相混淆，尤其在术中冰冻时。本文报道2例女性病例，分别发生于右肺下叶和左肺上叶，镜下表现为肿瘤组织呈腺样排列，主要由纤毛细胞、黏液细胞、立方细胞构成，基底细胞部分缺失。免疫表型：肿瘤细胞CK7、TTF-1、NapsinA均阳性，基底细胞p40、p63、CK5/6阳性(例2仅p63强弱不等)，p53呈野生型表达，EGFR阳性，Ki-67阳性指数分别约1%和10%，例2 ALK (D5F3)阳性、PD-L1 (SP263) TPS值 < 1%。通过本文报道的2例BA的复习，了解其病理形态及免疫表型特征，避免误诊。

Abstract: Bronchiolar adenoma (BA) is a relatively rare solid lung tumor newly defined by WHO (2021) in the field of chest tumors, with inert clinical manifestations, and is easily confused with mucinous ade-nocarcinoma, especially during intraoperative freezing. This article reports two female cases, occur-ring, respectively in the right lower lobe and left upper lobe. Microscopically, the tumor tissue ap-pears as glandular arrangement, mainly composed of ciliated cells, mucus cells, and cuboid cells, with partial absence of basal cells. Immunophenotypes: tumor cells CK7, TTF-1, and NapsinA are all positive, while basal cells p40, p63, and CK5/6 are positive (case 2 only shows varying strength of p63). p53 is expressed in the wild-type, EGFR is positive, and Ki-67 positivity index is about 1% and 10%. ALK (D5F3) of Case 2 is positive, and PD-L1 (SP263) TPS value is less than 1%. By reviewing the two cases of BA reported in this article, we aim to understand their pathological morphology and immunophenotypic characteristics to avoid misdiagnosis.