成人先天性肺囊性腺瘤样畸形临床病理观察  

Congenital Cystic Adenomatoid Malformation of Lung in Adults

作　　者：刘倩[1] 李丹[2] 丁兀兀[1] 邹庆[3] 吴宁[1] 孟红[1] 

机构地区：[1]德阳市人民医院病理科,四川德阳618000 [2]乐山市中医医院超声科 [3]德阳市人民医院放射科

出　　处：《华西医学》2016年第4期710-713,共4页West China Medical Journal

摘　　要：目的探讨成人先天性肺囊性腺瘤样畸形的临床病理特征。方法分析2012年11月19日及2014年2月12日收治的2例成人先天性肺囊性腺瘤样畸形的临床资料、病理组织学特征,并复习相关文献。结果 2例患者均为男性,年龄分别为59岁和60岁,均以咳嗽、咳痰、咯血、发热等呼吸道症状入院。病变均累及一侧肺叶,呈囊性,大小分别为4.0 cm×3.0 cm×1.5 cm、5.0 cm×5.0 cm×3.0 cm。显微镜下见正常的肺泡被腺瘤样增生的细支气管构成的囊腔所代替,囊腔大小不等,囊内壁衬覆假复层纤毛柱状上皮,囊壁含平滑肌和弹力组织,未见软骨。其中1例患者部分囊内壁可见黏液细胞衬覆,灶性上皮细胞非典型增生。结论先天性肺囊性腺瘤样畸形是一种罕见的先天性肺发育异常,多见于新生儿和婴儿,成人少见。结合临床特点、影像学改变及病理组织学特征可以明确诊断。Objective To investigate the clinicopathologic features of congenital cystic adenomatoid malformation（CCAM） of lung in adults.Methods The clinical and pathological characteristics of two cases of CCAM of lung in adults from November 19,2012 to February 12,2014 were analyzed,and relevant literatures were reviewed.Results Both of the two patients were males who were 59 years and 60 years old respectively.Both of them presented with respiratory symptoms such as productive cough,hemoptysis and fever.The lesions in the two cases were about 4.0 cm×3.0 cm×1.5 cm and 5.0 cm×5.0 cm×3.0 cm in size respectively.Both had a cystic appearance and involved unilateral lobes of the lung.Histologically,normal pulmonary alveoli were replaced by dif erent size of cysts composed of adenomatoid hyperplastic bronchioles.The inner cystic wall was lined by pseudostratii ed ciliated columnar epithelium,and the cystic wall contained smooth muscle and elastic tissue,but no cartilage.In one of our cases,mucous cells could be seen in part of the inner cystic wall,with focal atypical hyperplasia.Conclusions CCAM of the lung is a rare congenital developmental anomaly,which typically manifests in neonates and infants,but extremely rare in adults.The diagnosis of CCAM in adults depends on clinical features,imaging changes and histopathological characteristics.

关 键 词：肺 先天性肺囊性腺瘤样畸形 囊肿 临床病理 

分 类 号：R734.2[医药卫生—肿瘤]