肝脏血管平滑肌脂肪瘤临床病理分析  

Hepatic Angiomyolipoma:A Clinicopathological Study of 18 Cases

作　　者：李晓虹[1] 腾晓东[2] 魏萍[3] 章载良[3] 

机构地区：[1]杭州市红十字会医院病理科,杭州310000 [2]浙江大学医学院附属第一医院病理科 [3]浙江省湖州市解放军第98医院病理科

出　　处：《浙江中西医结合杂志》2009年第4期202-204,共3页Zhejiang Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的:探讨肝脏血管平滑肌脂肪瘤(hepatic angiomyolipoma,HAML)的病理形态学、免疫组化特征以及诊断、鉴别诊断要点。方法:对18例HAML病例进行组织学观察,HMB-45、Melan-A、Actin、Desmin、S-100、CK、Hep、AFP等免疫组织化学检测,并结合文献讨论。结果:18例HAML,位于肝左叶6例,右叶9例,双侧3例;镜下肿瘤由畸形厚壁血管、血管周梭形或上皮样细胞和脂肪细胞3种成分不同比例混合存在,可有某种成分的缺如;免疫组织化学检测显示血管周梭形或上皮样细胞HMB-45(+),Melan-A(+),Actin(+),Desmin(+),S-100(+),CK(-),Hep(-),AFP(-)。结论:HAML由多种成分组成,形态变化多样,血管周梭形或上皮样细胞表达HMB45或Melan-A(+)是诊断HAML的可靠证据。Objective： To study the elinicopathological and immunohistochemical features of hepatic angiomyolipoma （HAML） and the points of its diagnosis. Methods： The elinicopathological observation of 18 patients with HAML was retrospectively studied and related antibodies including HMB-45, Melan-A, Aetin, Desmin, S-100, CK, Hep and AFP were detected by immunohitochemistry. Results：Among this group ,6 HAML were involved in left liver lobe,9 in right lobe and 3 in both lobes. HAMLs were composed of abnormal blood vessels, perivascular epithelioid or fusiform ceils and adipose cells, which were mixed by means of different proportions. Any composition may be absent. Most perivaseular epithelioid or fusiform cells were positive for HBM-45, Melan-A, Aetin, Desmin and S-100 and negative for CK, Hep and AFP. Conclusion：HAMLs have 3 components and various microstructures. The expression of HMB-45 and Melan-A in smooth muscle cells was the key to tumor pathological diagnosis.

关 键 词：肝脏 血管平滑肌脂肪瘤 HMB-45 ACTIN 

分 类 号：R735.7[医药卫生—肿瘤] R730.4[医药卫生—临床医学]