硬化性肺细胞瘤11例病理特点及冷冻误诊分析  

Clinicopathologic features and misdiagnosis of pulmonary sclerosing haemangioma

作　　者：卢善明[1] 薛玲[2] 

机构地区：[1]梅州市人民医院病理科,广东梅州514031 [2]中山大学附属第一医院病理科,广州510080

出　　处：《诊断病理学杂志》2015年第12期749-752,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨硬化性肺细胞瘤(PSH)的临床病理特点,以提高对PSH术中冷冻诊断的准确性。方法收集11例PSH的临床资料,回顾性分析这些病例冷冻切片与石蜡切片的组织学特点。结果 PSH多见于中年女性,一般无临床症状。大体肿瘤边界较清。镜下观察到乳头状、实性、硬化性和血管瘤样结构及2种细胞。本组11例均行术中冷冻检查,5例诊断为PSH,3例诊断为良性肿瘤,3例未排除肺癌,需待石蜡切片确诊。7例冷冻切片见>3种组织结构,4例仅见2种组织结构,以1种组织结构(如实性结构或乳头状结构)为主。结论 PSH虽较为少见,但有必要纳入肺结节性病变冷冻检查的鉴别诊断范畴,此时肿瘤由2种细胞构成,肿瘤结构的多样性以及肿瘤与周围组织的明显界限是鉴别PSH与肺恶性肿瘤的重要标志。Objective To make a correct diagnosis at the time of intra-operative frozen section,the clinicopathologic features of pulmonary sclerosing haemangioma（ PSH） was discussed.Methods Clinical data of 11 cases of PSH were collected and their histopathologic features of frozen sections and paraffin-embedded sections were reviewed.Results PSH was most common in middle-aged females with asymptom.Most PSH showed four histological patterns（ papillary,solid,sclerotic and haemorrhagic） and two types of tumor cells in paraffin-embedded sections.At the time of intraoperative frozen section,5 cases were diagnosed as PSH,3 cases as benign tumor and the diagnosis was deferred in 3cases.The three or more histopathological patterns were identified in 7 cases and just two patterns in 4 cases with one predominant pattern such as solid or papillary pattern.Conclusion Although PSH is a rare tumor,it should be included in the differential diagnosis of lung nodule at the time of intra-operative frozen section.They are valuable characteristics to differentiate PSH from malignant lung tumor by two kinds of tumor cells,various histological patterns and discrete borderline between tumor and normal tissue.

关 键 词：肺硬化性血管瘤 临床病理 冷冻 

分 类 号：R734.2[医药卫生—肿瘤]