肺良性转移性平滑肌瘤1例报道及文献复习  

Plumonary benign metastasizing leiomyomas： a case report and review of literature

作　　者：汪丽娟[1] 孙振柱[1] 冷东明[1] 王春[1] 杨小丰[2] 

机构地区：[1]新疆维吾尔自治区人民医院病理科,新疆830001 [2]新疆维吾尔自治区人民医院PET-CT科,新疆830001

出　　处：《世界肿瘤杂志》2008年第1期49-51,共3页Tumour Journal of the World

摘　　要：目的探讨肺良性转移性平滑肌瘤的临床病理特征，组织发生及鉴别诊断。方法通过光镜、免疫组化染色，对一例肺良性转移性平滑肌瘤的病理学特点进行观察，并进行文献复习。结果巨检：楔形肺组织大小3cm×2cm×1cm，切面暗红，可见一直径0．5cm大小的结节，界清。光镜特点：瘤细胞为长梭形，呈束状、交织状排列，胞浆淡染，胞核梭形、类圆形，两端钝圆，染色质较粗，轻度异型，未见核分裂像。瘤组织与周围组织分界清楚，周边部为单层立方上皮细胞，瘤组织内可见上皮细胞衬里的裂隙，周围可见受挤压的肺泡结构。免疫组化特点-梭形瘤细胞SMA、Desmin、Vimentin、ER（个别细胞）、PR阳性，CK7、CK20、CD31、CD34、HMB45均阴性。结论肺良性转移性平滑肌瘤是一种来源于子宫平滑肌瘤的良性肿瘤，非常罕见，诊断时必须结合病史、影像学检查、病理组织学及免疫组织化学特点才能做出诊断。Objective To explore the clinical pathological characters, histogenesis and differential diagnosis of plumonary benign metastasizing leiomyoma. Methods A case of plumonary benign metastasizing leiomyoma was studied by histopathological observation and immunohistochemical staining and the related literature was reviewed. Results The tumor had regular margins and multiple well-defined nodules composed of interlacing bundles of smooth muscle cells with entrapped respiratory epithelium giving rise to a focally leaf-like pattern. The smooth muscle cells contained regular cigar-shaped nuclei and a fair amount of eosinophilic cytoplasm. No nuclear atypia, mitosis, or necrosis were identified.The histological appearance of the tumor was similar to that of the previously resected uterine leiomyoma. Immunohistochemical studies showed the spindle-shaped cell was positive for SMA, desmin, vimentin, ER and PR, and was negative for CK7, CK20, CD31, CD34, and HMB45. The present tumour was diagnosed as plumonary benign metastasizing leiomyomas. Conclusions Plumonary benign metastasizing leiomyoma might origin from uterine leiomyomas, and very infrequent. It is important to consider its case history, imaging examination, pathological histological and immunohistochemistical characters before diagnosing it.

关 键 词：良性转移性平滑肌瘤 病理组织学 

分 类 号：R73[医药卫生—肿瘤] R73-34[医药卫生—临床医学]