The differential diagnosis of lung adenosquamous carcinoma: well differentiated in the diagnosis of primary adenosquamous carcinoma of low malignant mucoepidermoid carcinoma (low-grademalignancy mucoepidermoid carcinoma, L-MEC) identification. Identification points: mucoepidermoid carcinoma in the bronchial segment or sub-section, is a central part; adenosquamous carcinoma mainly in the peripheral lung; low grade mucoepidermoid carcinoma, well differentiated glandular secretion of high columnar tubular fluid to teach some for clear cell glandular epithelium and eosinophils; and adenocarcinoma of the glands or papillary adenocarcinoma acinar adenocarcinoma; low malignant teach liquid skin squamous non-keratinizing carcinoma, adenosquamous carcinoma of the visible keratosis; straw liquid of low malignant epidermoid carcinoma transparent interstitial fibrosis occurred approved changes; adenosquamous carcinoma of interstitial fibrosis, but does not place a transparent change.
Poorly differentiated squamous cell carcinoma and a high degree of deterioration of gland mucoepidermoid carcinoma, solid adenocarcinoma, large cell, in the differential diagnosis of a certain degree of difficulty.
The differential diagnosis of lung adenosquamous carcinoma (1) high grade mucoepidermoid carcinoma (high-grade malignancy mucoepider-id carcinoma-MEC): H-MEC differentiation of difference may be as solid gland, adenoid structure, obviously, squamous cell significantly shaped nest cells, which is similar to poorly differentiated adenosquamous carcinoma. Two points on the identification; H-MEC occurs most often in large bronchi (paragraph above), is the central lung; and occurs in poorly differentiated adenosquamous carcinoma of the lung periphery; H-MEC can be found in the high juice, slices of low malignant Bo epidermoid carcinoma of the structure of liquid.
The differential diagnosis of lung adenosquamous carcinoma (2) solid adenocarcinoma: lack of clear and solid adenocarcinoma glandular structures, cell atypia out, and poorly differentiated adenosquamous carcinoma similar. Identification points: the light microscope, the solid adenocarcinoma of the gland is homogeneous in nature, and more can be found drawn adenoid structure of the total area of cells filled with mucus, resulting in more straw liquid (mucus staining is more obvious) . The uneven structure of poorly differentiated cancers, some cancer nests showed squamous differentiation, showing layered structure, the bridge between cells to find cancer cells in the mucus droplets; some glandular differentiation of cancer nest was to find not the typical structure, with larger number of mucous cells. In cancer tissues, squamous cell carcinoma and adenocarcinoma, history was the wrong order or separation zone. Mucus staining and immunohistochemistry some more easy to distinguish between squamous cell carcinoma; In the electron microscope, the more differentiated and poorly differentiated solid adenocarcinoma adenosquamous carcinoma. Real cancer in the electron microscope showed epithelial cells to differentiate; cells form glandular like structures, cells rich in microvilli, tight junctions, the cytoplasm is rich in mucus particles and development of the Golgi apparatus. In poorly differentiated adenosquamous carcinoma, differentiation of glandular epithelial cells were part of some squamous differentiation, some cells have both epithelial and squamous differentiation of micro-structure of positive characteristics.
The differential diagnosis of lung adenosquamous carcinoma (3) large cell carcinoma: large cell carcinoma in the light microscope does not have clear features of adenoid or squamous differentiation, but the individual cancer cells, there may be mucus droplets, and poorly differentiated adenosquamous carcinoma is not easy area, many drawn poorly differentiated adenosquamous carcinoma of the producer, can always find a light microscope to glandular or squamous epithelial differentiation characteristics of the histological structure. Mucus staining also helps to distinguish the direction of cancer differentiation. Large cell carcinoma or adenocarcinoma in the light microscope, the lack of the histological features of squamous cell cancer more extensive tissue necrosis. In poorly differentiated adenosquamous carcinoma and large cell carcinoma of the identification, the electron microscope has little significance.
- poorly differentiated adenosquamous carcinoma