伴骨及软骨化生的肺髓脂肪瘤1例  

A case of pulmonary myelolipoma with osseous and cartilaginous metaplasia

作　　者：刘磊玉[1] 苏友敢 毛飞 

机构地区：[1]湖北省中医院病理科,武汉430061 [2]上海迪安医学检验所有限公司,上海200433

出　　处：《国际病理科学与临床杂志》2012年第4期366-368,共3页Journal of International Pathology and Clinical Medicine

摘　　要：目的:探讨肺髓脂肪瘤的临床病理特点、诊断、鉴别诊断及肿瘤发生的来源。方法:复习1例肺髓脂肪瘤的临床资料,行组织学和免疫组织化学观察。结果:63岁患者CT强化扫描示左肺主支气管内一类圆形不均匀密度肿物,边缘光整。大体检查:肿瘤2 cm×1 cm×0.5 cm大小,切面灰白或灰黄色,质地不均,部分区域质硬如骨样组织。光镜显示:低倍镜见骨小梁组织环形围绕脂肪和造血样组织,局灶可见软骨组织。高倍镜见粒、红、巨核细胞系,三系细胞形态无异常。免疫组织化学染色显示:髓细胞髓过氧化物酶(+),巨核细胞CD61(+)。结论:肺髓脂肪瘤非常罕见,确诊依赖病理学检查,形态学典型,认识该疾病有助于避免临床影像学的误诊。Objective： To investigate the clinicopathologic features,diagnosis,differential diagnosis and tumor occurring sources of lung myelolipoma.Methods： Clinical data and histological and immunohistochemical observation were reviewed in a case of lung myelolipoma.Results： Enhanced CT scan showed a circular mass with uneven density and smooth edges in the left lung main bronchus of a 63-year-old male.Grossly,the tumor measured 2 cm×1 cm×0.5 cm.The cut surface disclosed gray and yellow areas,partly as hard as bone tissue,with uneven texture.Light microscopy showed hematopoietic elements admixed with adipose tissue and,focally,with cartilage tissue,and surrounded by a thin layer of trabecular bone.High magnification view showed myeloid,erythroid and megakaryocytic cells;there was no abnormality of cell morphology in the trilineage hematopoietic cells.Immunohistochemistry showed MPO-and CD61-positive for myeloid and megakaryocytic cell,respectively.Conclusion： Pulmonary myelolipoma is very rare.Definite diagnosis depends on typical morphology as revealed by histopathological examination,which may be useful to avoid clinical radiologic misdiagnosis.

关 键 词：髓脂肪瘤 化生 鉴别诊断 

分 类 号：R734.2[医药卫生—肿瘤]