卡波西样血管内皮瘤中的血液成份潴留现象  

Trapping of blood components in kaposiform hemangioendothelioma

作　　者：袁斯明[1,2] 王修坤[2] 沈卫民[3] 周晓军[1] 

机构地区：[1]南京军区南京总医院病理科 [2]南京军区南京总医院烧伤整形科,南京210002 [3]南京市儿童医院整形外科,南京210029

出　　处：《医学研究生学报》2012年第2期148-151,共4页Journal of Medical Postgraduates

基　　金：国家自然科学基金(30700874);中国博士后科学基金(20090451571);江苏省博士后科研资助计划(0901062C)

摘　　要：目的卡波西样血管内皮瘤(Kaporsiform hemangioendothelioma,KHE)常伴有Kasabach-Merritt现象,其特征是严重血小板减少和消耗性凝血病。以往推测Kasabach-Merritt现象的原因可能是血小板潴留于肿瘤中,该假说有待更多依据的证实。方法对1例伴有Kasabach-Merritt现象的KHE标本进行超微结构观察,以葡萄糖转移蛋白-1(glucose trans-porter 1,Glut1)作为标记抗原进行免疫组化染色,观察红细胞在肿瘤中的分布,并以不伴有Kasabach-Merritt现象的婴幼儿血管瘤作为对照。结果透射电镜可见肿瘤结节的狭缝状管腔中存在大量血小板、巨噬细胞和淋巴细胞,肿瘤内皮细胞细胞质中可见吞噬囊泡。免疫组化染色可见大量glut1阳性红细胞分布于狭缝状管腔中,而在婴幼儿血管瘤的微血管腔中未见上述血液成份。结论直接观察到血液成份潴留于KHE中,为了解Kasabach-Merritt现象的发生原因提供了直接的形态学证据。Objective Kaposiform hemangioendothelioma （ KHE）, a borderline tumor of endothelial origin, is associated with Kasabaeh-Merritt phenomenon, which is characterized by profound thrombocytopenia and eonsumptive coagulopathy. Previous studies have suggested that the trapping of platelets may underlie coagulopathy in KHE. However, more evidence is needed to support this hypothesis. Methods We collected samples of KHE complicated by Kasabach-Merritt phenomenon in one Chinese infant, con- ducted ultrastructural observation, performed immanohistochemical staining of Glutl, and analyzed the distribution of erythrocytes fantile hemangiomas without Kasabach-Merritt phenomenon were used as the control. Results Ultrastructural analysis revealed thetrapping of platelets, macrophages and lymphocytes in the slit-like channels of tumor nodules, and phagocytic vesicles in the cytoplasm of neoplastic cells. Immunohistochemical staining of Glutl showed many erythrocytes in the slit-like channels. No blood components were seen in the microvessels in infantile hemangiomas. Conclusion Our results provided compelling morphological evidence for the trap- ping of blood components in KHE.

关 键 词：卡波西样血管内皮瘤 Kasabach-Merritt现象 病理学 血液成份 

分 类 号：R730.231[医药卫生—肿瘤]