先天性肺囊性腺瘤样畸形的超微结构与组织分型对照分析  

Comparative analysis in ultrastructure and histological types for congenital cystic adenomatoid malformation

作　　者：洪淳[1] 俞钢[1] 张佳立[2] 郭雪贞[3] 

机构地区：[1]广东省妇幼保健院胎儿医学科,广州511400 [2]广东省妇幼保健院病理科,广州511400 [3]广东省妇幼保健院放射科,广州511400

出　　处：《中华实用儿科临床杂志》2016年第10期769-772,共4页Chinese Journal of Applied Clinical Pediatrics

基　　金：广东省医学科学技术研究基金（A2015549）

摘　　要：目的通过了解先天性肺囊性腺瘤样畸形（CCAM）的超微结构特征，探讨其影像分型与病理分型及电镜下超微结构之间的关系。方法选取广东省妇幼保健院2014年5月至11月问的CCAM病例，应用增强肺部CT进行影像学分型；将手术标本进行HE染色，并利用电镜技术，对比观察各分型的组织结构。结果选取8例CCAM作为研究对象，其中男5例，女3例；手术年龄（5．4±1．1）个月。影像学分型中，大囊型（Ⅰ型）（直径〉2cm）2例；小囊型（Ⅱ型）（直径≤2em）3例；微囊型（Ⅲ型）3例。病理分型Ⅰ型1例，Ⅱ型4例，Ⅲ型3例。其中1例CT分型为I型，病理分型为Ⅱ型；其余均一致。电镜下普遍显示为肺泡腔扩大，肺泡细胞减少，板层小体少，不成熟；微绒毛减少。从电镜角度分析，Ⅰ、Ⅱ型之间，并非有着明显区别。Ⅰ、Ⅱ型共同的特点包括了肺泡腔多以扩大为主，在扩大的肺泡腔之间存在少数受压缩小的肺泡腔；肺泡细胞均出现数量少、不成熟的表现，纤维组织增生。结论CCAM超微结构分析与临床病理分型存在差异，提示了电镜超微结构分析与病理的结合对于CCAM分型的重要性。需要进一步进行光镜一电镜的对照分型；并结合随访作出相关的预测模型。Objective To explore relationship between imaging classification and pathological type,and the e- lectron microscopic ultrastructure by observing the uhrastructural features of congenital cystic adenomatoid malformation （CCAM）. Methods Children with CCAM in the Guangdong Women and Children Hospital from May 2014 to November 2014,were analyzed, imaging classification was performed according to enhanced Computed Tomography （CT） scan- ning, and the surgical specimens were stained by HE and scanning electron microscope was used to observe the tissue structures of various of CCAM. Results Eight cases were enrolled in this research （5 boys and 3 gifts）, and the mean age of surgery was （ 5.4 ± 1.1 ） month old. According to the features of enhanced CT scanning, there were 2 cases of the type - Ⅰ , and the other 3 cases of type - Ⅱ , and 3 cases of type - Ⅲ ; According to the characteristics of the pathologi- cal types,there was 1 case of type - Ⅰ ,4 cases of type - Ⅱ ,and the other 3 cases of type - Ⅲ. There was 1 case which classified as type - Ⅰ by CT, however classified as type - Ⅱ by pathological typing. The findings of CT features were in complete correspondence with the pathological types in the rest cases. Electron microscopic findings showed the alveolar spaces were enlarged, the alveolar cells were reduced, the lamellar bodies were decreased and immature and microvilli were also decreased. There was no significant difference between Ⅰ and Ⅱ type under the viewpoint of electron micro- scope. The common features between type Ⅰ , and type Ⅱ included that the alveolar space was enlarged, the alveolar space had been pressed between enlarged alveolar space, the alveolar cell were decreased and immature, and fibrous hy- pertrophy was also found. Conclusions There are differences between ultrastructural analysis and clinical pathological typing which suggests the clinical importance of the electron microscopy uhrastructural analysis combined with pathology for typing. There need

关 键 词：先天性肺囊性腺瘤样畸形 显微电镜分析 病理 

分 类 号：R725.6[医药卫生—儿科]