IHC：P63、WT-1、SMA、Calponin、EMA、CEA均阴性
CK7和CK8/18约70%阳性，Vimentin（++）、S-100++、GFAP网状间叶成分阳性，实体成分阴性。CKpan+

a function of the neoplastic myoepithelium, which shows histological and immunophenotypical variability.
Wilms’ tumor 1 gene (WT1) protein, involved in bidirectional mesenchymal–epithelial transition, has been
detected by reverse transcription PCR in salivary gland tumors showing myoepithelial–epithelial differentiation.
The aim of this study was to investigate the immunoreactivity of WT1 in pleomorphic adenomas and to compare
the pattern of staining with p63 and calponin, two reliable markers of myoepithelial cells. A total of 31 cases of
pleomorphic adenoma were selected. The myoepithelium was classified as myoepithelial-like (juxtatubular and
spindled), modified myoepithelium (myxoid, chondroid and plasmacytoid) and transformed myoepithelium
(solid epithelioid, squamous and basaloid cribriform). Immunohistochemistry for WT1, p63 and calponin was
assessed in each myoepithelial component, as well as in nonneoplastic myoepithelial cells and inner tubular
epithelial cells. There was no immunostaining of tubular epithelial cells by any of the markers. In contrast to p63
and calponin, WT1 did not react with normal myoepithelial cells. Cytoplasmic WT1 staining was present in all
pleomorphic adenomas, and in 29 cases (94%), >50% of neoplastic myoepithelial cells were highlighted.
p63 and calponin stained the myoepithelium in 30 tumors. In comparison, 50% of cells were positive in 21
(68%) and 9 (29%) cases of p63 and calponin, respectively. Staining with WT1 showed less variability across the
spectrum of myoepithelial differentiation with the difference most marked in the transformed myoepithelium.
WT1 is a sensitive marker of the neoplastic myoepithelial cell in pleomorphic adenomas. The role of this protein
in influencing the mesenchymal–epithelial state of cells suggests that WT1 and the myoepithelial cell have an
important role in the histogenesis of pleomorphic adenomas

本例WT-1做了2次均阴性，不知道是不是试剂型号的原因,我们的结果和文献很不一样呢！

本例主要在PA和PLGA之间鉴别，IHC一定程度上支持PLGA，但形态学更像PA，纠结

IHC比较支持肌上皮分化的是GFAP有明显的网状肿瘤样成分表达，但郁闷的是实体成分全阴性

有篇文献提到少数多形性腺瘤PA可以是GFAP局灶阳性，主要是网状间质表达，而PLGA一般阴性，即使阳性也是局灶上皮成分表达弱的GFAP，那么究竟咋整

多形性腺瘤

混合瘤

多形性腺瘤/肌上皮瘤，更多的表型倾向后者。

多形性腺瘤