结节性组织细胞／间皮增生七例临床病理分析  

Nodular histiocytic/mesothelial hyperplasia： a clinicopathologic analysis of 7 cases

作　　者：蔡兆根[1] 谢群[1] 王晓明[1] 郭冰沁[1] 王欣[1] 王坤[1] 

机构地区：[1]安徽蚌埠医学院第一附属医院病理科蚌埠医学院病理学教研室,233003

出　　处：《中华病理学杂志》2014年第4期256-259,共4页Chinese Journal of Pathology

摘　　要：目的探讨结节性组织细胞／间皮增生的临床病理特征及免疫组织化学特点，以提高对该病的认识。方法收集结节性组织细胞／问皮增生7例，对其临床、病理及免疫组织化学资料进行分析并进行文献复习。结果7例均为男性，年龄1．5～5．0岁，平均2．8岁。临床以腹股沟肿块为主要症状就诊。病理学大体改变主要为附壁结节或腔内游离的结节，直径0．1～0．5cm；镜下观察瘤细胞形态较单一，呈椭圆形、多边形，实性片状或巢状分布，胞质淡红染，核圆形、卵圆形，染色质较细腻，无明显异型性，其间散在少量淋巴细胞浸润；囊壁由薄层纤维及血管构成，内衬间皮细胞。免疫组织化学标记：结节区CD68弥漫强阳性，CD45、波形蛋白和α1-抗胰糜蛋白酶阳性，calretinin、间皮细胞抗体、WTI、CK5／6、广谱细胞角蛋白、上皮细胞膜抗原为囊壁内衬的间皮细胞阳性。结论结节性组织细胞／间皮增生是一种甚为少见的良性肿瘤样病变，容易误诊，形态学需与神经内分泌肿瘤、朗格汉斯细胞组织细胞增生症、精原细胞瘤和间皮瘤等相鉴别，综合临床特点和HE形态以及免疫组织化学能做出正确诊断。Objective To analyze the clinicopathologic and immunohistochemical features of nodular histiocytic/mesothelial hyperplasia （NHMH） and to improve the knowledge of this disease. Methods Seven cases of NHMH were collected and the clinicopathologic and immunohistochemical data were analyzed with review of the literature. Results Seven male patients aged from 1.5 to 5.0 years （ mean 2, 8）. The main clinical symptom was an inguinal mass. Grossly, main pathological changes were the mural nodule or free nodule in lumen, with diameter of 0. 1-0. 5 cm. Histologically, the tumor cell morphology was relatively single, cohesive polygonal or oval ceils which were arranged in solid sheets or nests, usually with ovoid or deeply grooved nuclei and a moderate amount of pale pink cytoplasm in the nodular collection area. The nuclei had delicate chromatin and no obvious atypia, and mitosis was incidentally found. A few scattered lymphocytes were found in the stroma. The cyst wall was lined by a single layer of mesothelial cells. Immunohistochemically, the most cells in nodular lesion were strongly positive for the histiocytic marker CD68, vimentin and c^l-antichymotrypsin, while lining mesothelial cells on the wall were positive for calretinin, MC, WTI, CK5/6, CKpan and EMA. Conclusions NHMH is a rare and benign tumor-like lesion, and easy to be misdiagnozed, which should be distinguished from neuroendocrine tumors, Langerhans cell histiocytosis, seminoma, mesothelioma and so on. The correct diagnosis of this lesion depends on the clinical characteristics, morphology and immunohistochenfistrv.

关 键 词：结缔组织细胞 局灶性上皮增生 免疫组织化学 

分 类 号：R691[医药卫生—泌尿科学]