上皮样血管平滑肌脂肪瘤1例病理观察及文献复习  

One cases report of epithelioid angiomyolipoma (EAML)of liver

作　　者：袁勇 张娟 黄颖楠 葛红菊 

机构地区：[1]陕西省肿瘤医院病理科,陕西西安710061

出　　处：《现代肿瘤医学》2009年第9期1776-1780,共5页Journal of Modern Oncology

摘　　要：目的:探讨上皮样血管平滑肌脂肪瘤的临床病理学特点、免疫组化及鉴别诊断。结合文献对其临床病理学特征、诊断和鉴别诊断、生物学行为、组织发生、流行病学和遗传学等进行讨论。方法:对1例肝上皮样血管平滑肌脂肪瘤(EAML)进行组织形态、免疫组化观察和文献复习,病理诊断及鉴别诊断。结果:组织学显示上皮样血管平滑肌脂肪瘤的肿瘤细胞多呈巢状和片状排列,肿瘤细胞体积大,多边形或梭形,有丰富的嗜酸性颗粒状胞浆,细胞核较大,核仁明显呈空泡状。可由单核或多核的上皮样细胞构成,特别是当肿瘤显示不典型的特征时很容易与有些肿瘤混淆。免疫组化肿瘤细胞、黑色素(HMB-45)阳性、结蛋白、肌动蛋白和波形蛋白弥漫阳性或散在阳性而上皮细胞膜抗原阴性。结论:上皮样血管平滑肌脂肪瘤(EAML),是血管平滑肌脂肪瘤(AML)的罕见亚型。是一种具有恶性潜能的间叶源性肿瘤,免疫组化对鉴别诊断有重要意义。Objective： To discuss the clinicopathologic features and pathological diagnosis as well as differential diagnosis of EAML of the liver. Methods： one case of EAML was investigated pathologically and immunohistochemi cally. Results： Microscopically,the tumor cells of one case of EAML of the liver were arranged in the shape of nests or slicing. The epithelioid cells had huge volume in polygon or diamond shape and were full of abundant eosinophilic cytoplasm. The nucleus were more large and the center of nucleus was obviously emptily bubble - shaped. Immunohistochemically,tumor cells HMB45, vimentin, desmin, actin and CD68 were positive. While CKE1/AE3 and epithelial membrane antigen （EMA） were negative. Conclusion： Renal epithelioid angiomyolipoma was a mild malignant tumor before distant metastases. The immunohistochemistry was of great significance in differentiating diagnoses.

关 键 词：上皮样血管平滑肌脂肪瘤 免疫组织化学 临床病理特点 诊断 鉴别诊断 生物学行为 组织发生 

分 类 号：R730.262[医药卫生—肿瘤]