增殖期血管瘤和卡波西样血管内皮瘤的病理比较研究  

Comparative Study On Pathology of Proliferating Infantile Hemangioma and Kaporsiform Hemangioendothelioma

作　　者：袁斯明[1,2] 沈卫民[3] 王修坤[2] 陈荣亮[2] 周航波[1] 姚育英[1] 章如松[1] 周晓军[1] 

机构地区：[1]南京军区南京总医院病理科,江苏省南京市210002 [2]南京军区南京总医院整形外科,江苏省南京市210002 [3]南京市儿童医院整形外科,江苏省南京市210008

出　　处：《组织工程与重建外科杂志》2010年第2期85-88,共4页Journal of Tissue Engineering and Reconstructive Surgery

基　　金：国家自然科学基金项目(30700874);中国博士后科学基金项目(20090451571);江苏省博士后科研资助计划项目(0901062C);南京军区南京总医院科研基金资助(2009Q038)

摘　　要：目的正确鉴别体表软组织深部的增殖期婴幼儿血管瘤(Infantile hemangioma,IH)和卡波西样血管内皮瘤(Kaporsiform Hemangioendothelioma,KHE)是选择合适治疗方案的重要条件。从多方面比较增殖期IH和KHE的病理特征,为更准确地鉴别诊断这两种疾病提供依据。方法在2001年1月至2009年6月期间,收集21例增殖期IH和12例KHE标本。采用HE染色、透射电镜和免疫组化染色等方法,比较增殖期IH和KHE的病理结构和抗原标记(D2-40和Glut1)的表达。结果 HE染色显示,增殖期IH有众多毛细血管丛,新生毛细血管壁内可见扁平状周细胞;KHE由肿瘤结节组成,结节中心是大量狭缝状管腔,结节边缘可见毛细血管。在电镜下观察,增殖期IH的毛细血管壁基底膜呈多层板状结构,基底膜内有周细胞;KHE的狭缝状管腔和毛细血管壁基底膜仅有数层,且不连续,基底膜内也可见周细胞。增殖期IH肿瘤内皮细胞不表达D2-40,强烈表达Glut1;而KHE仅表达D2-40,不表达Glut1。结论增殖期IH的病理结构与KHE有明显差别。D2-40和Glut1可以作为鉴别增殖期IH和KHE的可靠抗原标记。Objective To distinguish proliferating infantile hemangioma （IH） and kaporsiform hemangioendothelioma （KHE） by comparing the pathological structure and marker antigen expression. Methods From January 2001 to June 2009, 33 paraffin-embedded and fresh samples, 21 proliferating IH and 11 KHE, were collected from Nanjing Children＇s Hospital and Jinling Hospital. Hematoxylin-eosin （HE） staining and transmission electron microscopy （TEM） were used to observe the pathological structure. Immunohistochemical analysis was also performed to investigate the expression of D2-40 and Glutl. Results HE staining revealed that proliferating IH had dense capillary plexus and flat pericytes in the wall of neo- capillaries, and that KHE was composed of tumor nodules with slit-like channels in the center and capillaries in the margin. TEM revealed multi-layer basement membrane of neo-capllaries in IH, and slit-like channels and capillaries with thin- layered basement membrane in KHE. There were pericytes in the basement membrane in both. Immunochemistry revealed that the endothelial cells expressed Glut1, but not D2-40 in IH; while D2-40, but not Glutl in KHE. Conclusion The pathological structure of proliferating IH is obviously different from that of KHE. D2-40 and Glut1 are the reliable marker antigens for differential diagnosis of proliferating IH and KHE.

关 键 词：婴幼儿血管瘤 卡波西样血管内皮瘤 病理学 抗原标记 

分 类 号：R730.4[医药卫生—肿瘤]