肺的一种良性神经内分泌肿瘤──对所谓肺硬化性血管瘤来源的探讨  

A benign neuroendocrine tumor of the lung:study on the origin of the so-called sclerosing hemangioma of the lung

作　　者：李维华[1] 许红民[1] 李红芬[1] 于占洋[1] 王淑琴[1] 李志军[1] 赵武宪[1] 

机构地区：[1]北京中国人民解放军总医院病理科

出　　处：《中华病理学杂志》1994年第2期69-72,T016,17,共4页Chinese Journal of Pathology

摘　　要：对３１例所谓肺硬化性血管瘤（又称为肺腺瘤或假乳头瘤型及硬化性血管瘤型肺炎性假瘤）进行了大体及组织学观察，并对其中大部分病例做了１１种免疫组化染色和部分病例电镜观察。结果表明：８６％及全部病例ＣｇＡ和ＮＳＥ呈阳性（其瘤细胞的阳性率分别为７６％和８２％），７３％～７９％的病例有降钙素、胃泌素、生长激素和促肾上腺皮质激素２～４种激素表达（其瘤细胞的阳性率为３７％～７５％）；Ｋｅｒａｔｉｈ、第Ⅷ因产和α－ＡＴ为阴性反应；在电镜下瘤细胞胞浆内见有数量不等的神经分泌颗粒。所见提示此瘤是一种尚未见报道的来自肺神经内分泌细胞的良性肿瘤，暂命名为肺良性神经内分泌瘤（ＬＢＮＥＴ）。1 cases of the so-called sclerosing hcmangiomas of the lung were studied by light microscope,immunohistochemical and electron microscopy.This tumor is benign and has 3 histologic patterns:papillary,hemangioma-like and solid type. Characteristic morphology being unifoim round tumor cells,lying within the stroma in different patterns and regarded as the major component of sclerosing hemangioma,expressing neuroendocrine markers which include chromograin A,neuron-specific enolase,ACTH, growth hormone,calcitonin and gastrin. Only a few tumor cells were positive for epithelial mem-brane antigen(EMA) and carcinoembryonic antigen(CEA),all the tumor cells were negative for keratin(Polyclonal,Z622)stain. However,in contrast to the round tumor cells,the cells lining papillary projec-tions or cystic spaces,which presented as normal or hyperplastic alveolar cells,stained positive for keratin,EMA and CEA but negative for neuroendocrine markers. Both the surface cells and tumor cells were negative for Factor Ⅷ-related antigen and α1-AT. Therefore, pulmonary sclerosing hemangioma was regarded to be a benign tumor originating from the neuroendocrine cells of the lung and we suggest that it be renamed as benign neurocndocrine tumor of the lung(LBNET).This viewpoint has not been previously reported in the literature.

关 键 词：肺肿瘤 免疫组织学 血管瘤 

分 类 号：R734.202[医药卫生—肿瘤]