肝血管平滑肌脂肪瘤3例临床病理分析  

Hepatic Angiomyolipoma: A Clinicopathological Study of Three Cases

作　　者：张丽华[1] 吕翔[1] 黄志勇[1] 聂进军[1] 周强[1] 周祀侨[1] 

机构地区：[1]南京大学医学院附属鼓楼医院病理科,南京210008

出　　处：《诊断病理学杂志》2001年第2期82-84,I026,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的　对肝血管平滑肌脂肪瘤的临床病理特点、免疫组化、诊断及鉴别诊断进行探讨。方法　 3例肝AML标本均经常规处理 ,HE染色和S P法免疫组化染色 ,光镜观察。结果　肿瘤位于肝左叶 2例 ,肝右叶 1例。 3例肿瘤内均可见平滑肌、脂肪、畸形血管及造血细胞 ,其中上皮样平滑肌细胞为肿瘤的主要成分 (>90 % ) ,瘤细胞排列呈弥漫片状、条索状或小梁状。 1例肿瘤中可见炎性假瘤样区域。免疫组化染色上皮样平滑肌细胞表达HMB45强阳性。术后随访 3～ 31个月 ,未见肿瘤复发。结论　肝AML的形态学特点有别于肾AML ,肿瘤中 3种成分的比例、瘤细胞形态及组织结构均有很大变化 ,必须与多种肿瘤相鉴别。平滑肌细胞表达HMB45强阳性 。Objective To investigate the clinicopathological and immunohistochemical characteristics of hepatic angiomyolipoma. Methods Hematoxylin Eosin and SP immunohistochemical stains were performed to explore the histopathologic changes and expression of HMB 45 in three cases of hepatic angiomyolipoma. Results Of the 3 cases, one was male and 2 female. The age of the patients ranged from 29 to 51 years. Two tumors were located in the left lobe and one in the right lobe of the liver. Microscopically, all the three tumors were composed of smooth muscle cells, fat cells, malformed vessels and heamtopoietic elements. The predominant component of the tumor was epitheloid cell of smooth muscle, which accounted for about 90% of the tumor. The epitheloid cells arranged in large solid sheets, cords and trabecular patterns. Inflammatory pseudotumor like area was found in one case. The epitheloid cells in all tumors showed over expression of HMB 45. The follow up data revealed that all the patients were alive without recurrence for 3 to 31 months after operation. Conclusions Morphological features of angiomyolipoma in the liver are quite different from that in the kidney. Over expression of HMB 45 is found in all the tumor, which is a reliable marker in the diagnosis of hepatic angiomyolipoma.

关 键 词：肝肿瘤 血管平滑肌脂肪瘤 免疫组织化学 HMB45 临床病理 

分 类 号：R735.7[医药卫生—肿瘤]