肺硬化性血管瘤3例临床病理学分析
血管瘤,,肺肿瘤；,血管瘤；,免疫组织化学；,诊断,1资料和方法,2结果,3讨论,参考文献:
摘要： 目的： 探讨肺硬化性血管瘤(SHL)的临床病理形态特征、组织起源、良恶性及鉴别诊断。方法： 对3例SHL患者的临床病理资料进行回顾性分析，并对其组织标本进行上皮膜抗原(EMA)、细胞角蛋白(CK, AE1/AE3)、波形蛋白(Vim)、嗜铬粒素A(Cg A)、突触素(Syn)、CD34、雌激素受体(ER)、孕激素受体(PR)、神经元特异性烯醇化酶(NSE)、第八因子(F8)等免疫组织化学标记。结果： 3例SHL患者均为女性，表现为肺内孤立性肿块，瘤体直径3～4 cm，镜下瘤组织结构多样，主要表现为实性、乳头状、血管瘤样、硬化4种结构不同比例混合存在；瘤细胞主要有多角形细胞和表面立方形细胞，前者同时表达EMA、Vim和PR,而后者仅CK阳性，1例偶有少数细胞Syn阳性。结论： 肺硬化性血管瘤可能起源于多潜能原始呼吸道上皮细胞；EMA、Vim、 CK等免疫标记对诊断有帮助。关键词： 肺肿瘤； 血管瘤； 免疫组织化学； 诊断
A clinical and pathological study of sclerosing hemangiomas of lung(report of 3 patients)
FANG Xinzhi, Li Yiqun, Yu Anqing
(Department of Pathology, Affiliated Tumor Hospital, Xinjiang Medical University,Urumqi 830011, China)
Abstract: Objective: To investigate the clinical and pathological features, histogenesis, benign or malignancy and differential diagnosis of sclerosing hemangiomas of lung (SHL). Methods: Three cases of SHL were reevaluated and were immunostained with a panel of antibodies including EMA, CK(AE1/AE3), vimentin, etc. Results: Three cases were female. Tumors were 3～4 cm in diameter solitary round or nearly round mass or nodule in lung. All cases showed the classic histological features with variable proportions of solid, papillary, hemorrhagic and sclerotic pattern. The tumors consisted of two predominant cell types: pale polygonal cells and cuboid or columnar cells. Both EMA and vimentin expressions were observed in the pale polygonal cells, CK only be seen in cuboid or columnar cells in the three cases. In only one case synaptophysin showed a few positive expressions in cuboid or columnar cells. Conclusions: SHL usually occur in female and is not easy to diagnosis clinically. It is suggested that SHL is an epithelial neoplasm derived from primitive respiratory epithelium. The immunohistochemical markers such as EMA, vimentin, CK are helpful for diagnosis. ......
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