肺硬化性血管瘤临床病理及免疫表型特征分析  

Clinicopathological characteristics and immunophenotype of pulmonary sclerosing hemangioma

作　　者：高金莉[1] 董志广[1] 

机构地区：[1]河南省濮阳市人民医院病理科,河南濮阳457000

出　　处：《中国现代医生》2013年第5期92-93,F0003,共3页China Modern Doctor

摘　　要：目的探讨肺硬化性血管瘤(pulmonary sclerosing hemangioma,PSH)临床病理及免疫表型特点。方法对48例肺硬化性血管瘤患者进行HE染色及免疫组化染色,光镜观察。结果 PSH由乳头状结构、实性结构、海绵状血管瘤样结构和硬化区4种结构组成。瘤细胞有2种,一种是被覆乳头表面、实性区裂隙和血管瘤样腔面的立方状细胞,一种是实性区及乳头轴心大小形态一致的圆形或多角形细胞。免疫组化染色显示,立方状细胞表达广谱CK、CK7、EMA和TTF1,圆形或多角形细胞表达EMA、TTF1、ER、PR、vimentin、Ki-67,部分病例两种细胞不同程度散在表达CgA、Syn。结论 PSH是一种肺内少见的肿瘤,多见于中青年女性,易误诊为肺癌。典型的组织形态学特征结合免疫组化染色,特别是Ki-67特征性的在胞膜表达,是诊断和鉴别诊断PSH的主要方法。Objective To study the clinicopathological characteristics and immunophenotype of pulmonary sclerosing hemangioma （PSH）. Methods A total of 48 cases of PSH were studied by HE stain and immunohistochemical stains and light microscopy. Results HE staining revealed that PSH showed a mixture of the following four histological pat- terns： papillary, solid, hemangioma-like and sclerotic. There were two types of tumor cells： cuboidal cells covered the papillary surface , and lined fissure-cavity in the solid and hemangioma-like areas, and round or polygonal cells with consistent size and morphology in the solid areas papillary axis. Immunohistochemical staining reaveled that the cuboid cells expressed CK （Pan）, CK7, EMA and TTF1, and round or polygonal cells expressed EMA, TTF1, ER, PR, vimentin, and Ki-67. Sporadic expression of CgA and Syn was observed in a few cases. Conclusion PSH is a rare lung tumor, particularly prevalent in young and middle-aged women, and often misdiagnosed as lung cancer. Morphological analy- ses and immunohistochemical stains, especially Ki-67 expressed in cell membrane ,are the main approaches for the diagnosis and differential diagnosis.

关 键 词：肺肿瘤 硬化性血管瘤 临床病理 免疫表型 

分 类 号：R734.2[医药卫生—肿瘤]