小唾液腺由来の多形性腺腫の3症例とその病理組織像の比較

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Pleomorphic adenoma is the most common tumor of salivary glands. Most of them are seen in major salivary glands, and the minor salivary gland tumor is mainly seen at the palate. The minor salivary gland tumor is rarely found in the upper lip or the cheek. We experienced three cases of plcomorphic adenomas in the upper lip and the cheek, and evaluated these histopathological characteristics. In case 1, at the left side of the upper lip, the tumor histopathology showed a predominantly epithelial pattern composed of two layers of tumor cells which formed irregularly dilated lumen structures. Hyaline degeneration was extensive in the stroma. In this case, diffuse fatty tissue seeming to be fatty degeneration was seen in the stroma. In case 2, at the right cheek, the histopathology demonstrated predominantly myoepithelial pattern composed of solid proliferation of spindle or polygonal tumor cells. In case 3, at the left side of the upper lip was a predominatly myxoid pattern composed of wide-spread myxoid stroma, and cellular components were very few. According to the classification based on the developmental stage of pleomorphic adenoma by Funahashi (1985), the tumor of case 1 seemed to be a metaplastic stage; of case 2, a proliferative stage; and of case 3, a degenerative stage. In case 2, the myxomatous change and the hyalinization of the stroma were partly seen, these phenomena might be a transitional stage from the proliferative to the metaplastic stages. The fibrous capsule was thin in all cases. There were slight differences in thickness among these cases; in cases 1 and 2, the capsule was slight thicker than that of case 3. In case 1, the daughter lesions of the tumor scattered in the capsule. We evaluated the characteristics of collagen in each case with collagen stain. The collagen fibers were mainly seen around the nest of solidly proliferating tumor cells. In the myxomatous area, there were few collagen fibers. The collagen fiber partially lost its continuity around the nest of tumor cells. The invasive or germinative growth of tumor cells to the stroma was seen in that area. Malignant changes in pleomorphic adenoma have been occasionally reported, so careful diagnosis and long-term follow-up are necessary.

小唾液腺由来の多形性腺腫の3症例とその病理組織像の比較

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