原发性心包恶性间皮瘤的临床病理和免疫组化分析  

Primary malignant pericardial mesothelioma:clinicopathological and immunohistochemical analysis

作　　者：任刚[1] 于国[1] 晋薇[1] 王殿军[1] 

机构地区：[1]解放军总医院病理科,北京100853

出　　处：《解放军医学杂志》2007年第8期853-855,共3页Medical Journal of Chinese People's Liberation Army

摘　　要：目的探讨原发性心包恶性间皮瘤的临床病理诊断及其免疫组化表达的意义。方法对7例原发性心包恶性间皮瘤进行临床病理分析、免疫组化及组织化学观察,并复习相关文献。结果7例中女性4例,男性3例,平均年龄40(22～51)岁。穿刺活检3例,手术标本4例,其中尸检2例。主要临床表现为心悸,尤其活动后心悸加重、气短,病程最长为4年,平均12个月。病理组织学形态表现为腺管样型2例、腺管乳头状型2例、印戒样细胞型1例及纤维母细胞型2例。尸检2例大体见心包膜均弥漫性增厚,1例转移至右肺、纵隔及肺门淋巴结,另一例转移至右肾。免疫组化显示,肿瘤细胞对CK5/6、Calretinin、CK、Vimentin、及EMA均呈阳性表达。7例CI染色均呈不同程度阳性改变,而对HCI染色则呈阴性。结论免疫组化、组织化学对该肿瘤的诊断及鉴别诊断具有意义。Objective To explore the clinicopathological and immunohistoehemical features of primary malignant pericardial mesotheliorna. Methods Seven cases of primary malignant pericardial mesothelioma, in 4 females and 3 males, with the age ranged from 22 to 51 and a mean of 40 years old, were studied with clinicopathological, immunohistochemical and histoehemical techniques. The pertinent literature was also comprehensively reviewed. Results 3 biopsy specimens and 4 surgical specimens, including 2 autopsy specimens, were studled. The main clinical symptoms were palpitation and short breath, which were aggravated after movement. The longest course was 4 years, and the mean disease course was 12 months. The chest films demonstrated an obviously increase in heart shadow, and the pericardium was thickened in some cases. CT clearly showed tumorous shadow in 2 cases. The histopathologic picture showed tubular type in 2 cases, papillary in 2, signet ring cell type in 1 and myofibroblast types in 2. In 2 autopsy specimens it was found that pericardium was diffusely thickened. In one case the tumor was metastasized to the right lung, mediastinum, and pulmonary hilar lymph node. In another case there was metastasis to right kidney. Immunohistoehemical staining showed that the neoplastic cells of all cases were positive for CK5/6, calretinin, CK. vimentin and EMA, but negative for CEA. In the histoehemical staining seven cases, the malignancy was positive for CI to different extent, but negative for HCI. Conclusion Immunohistochemistry and histoehemistry play an important role in diagnosis and differential diagnosis for primary malignant mesothelioma and other tumors in pericardium.

关 键 词：间皮瘤 心包 病理学 临床 免疫组织化学 

分 类 号：R362[医药卫生—病理学]