1例印戒细胞样型恶性间皮瘤的临床病理分析  

Signet ring cell type of malignant mesothelioma:a case of clinical and pathological analysis

作　　者：吴雪辉[1] 韩林[1] 李爽[1] 李幸子 

机构地区：[1]三峡大学人民医院病理科,湖北宜昌443000

出　　处：《现代医学》2017年第1期116-119,共4页Modern Medical Journal

摘　　要：目的:探讨印戒细胞样型恶性间皮瘤的临床病理诊断、鉴别诊断及其预后。方法:对1例印戒细胞样型恶性间皮瘤进行临床病理分析、免疫组化及组织化学观察,并复习相关文献。结果:印戒细胞样型恶性间皮瘤临床表现多样,发生在胸膜早期常无症状或仅表现运动后气促,最常见的症状是呼吸困难和胸痛,发生在心包则早期常出现心慌、气短等症状。病理组织学形态特征以印戒样细胞为主,弥漫分布,细胞大小不一,有异型性,可见少许腺样结构。免疫组织化学:肿瘤细胞对Calretinin、D2-40、CK5&6、EMA、Vimentin呈阳性表达,CEA、TTF1及Naspin A呈阴性。组织化学:CI染色均阳性,HCI染色阴性。结论:印戒细胞样型恶性间皮瘤是罕见的恶性间皮瘤的一种亚型,其诊断应从临床部位、组织形态、免疫组化及组织化学等多方面综合考虑。Objective： To study the pathological characteristics of Signet ring cell type of malignant mesothelioma and analyze the clinical data. Methods： A case of the signet ring cell type of malignant mesothelioma was studied and analyzed of its clinicopathological characteristics and histochemistry with immunohistochemistry, and the related literature was reviewed. Results： Malignant mesothelioma has various manifestations in clinic. The most common symptoms were dyspnea and chest pain if it happened in the early stage of membrana pleuralis, secondly palpitation and short breath if it happened in pericardium. The histopathologic feature showed dominantly signet ring cells, distributing in a diffuse way with different size and heteromorphism, a few cavities like gland can be observed. Immunohistochemically, the tumor cells were positive for Calretinin, D2-40, CK5＆6, EMA and Vimentin but negative for CEA, TTF1 and NaspinA. Histochemistry study showed that CI was positive while HCI was negative in the cases. Condusion： Being a rare subtype of malignant mesothelioma, the diagnosis of Signet ring cell type of malignant mesothelioma should consider the tumor＇s position, morphological performance, histochemistry and immunohistochemistry.

关 键 词：恶性间皮瘤 胸膜 印戒样细胞 鉴别诊断 

分 类 号：R734.3[医药卫生—肿瘤]