原发性肺脑膜瘤4例临床病理分析及文献复习  

Primary pulmonary meningioma:a clinicalpathologic analysis of four cases and review of the literature

作　　者：张慧芝[1] 沈晓涵[1] 王素英[1] 王淑妍[1] ZHANG Hui-zhi;SHEN Xiao-han;WANG Su-ying;WANG Shu-yan(Ningbo Clinicopathological Diagnosis Center/Ningbo Pathological Center of Shanghai Cancer Hospital,Ningbo 315000,China)

机构地区：[1]宁波市临床病理诊断中心/上海市肿瘤医院宁波病理中心,宁波315000

出　　处：《临床与实验病理学杂志》2018年第9期997-1000,共4页Chinese Journal of Clinical and Experimental Pathology

基　　金：宁波市自然科学基金(2016A610186);浙江省医药卫生科研基金项目(2017KY607)

摘　　要：目的探讨原发性肺脑膜瘤(primary pulmonary meningioma,PPM)的临床病理学特点、免疫表型及鉴别诊断。方法收集4例PPM进行临床病理学观察和免疫组化标记,并进行相关文献复习。结果 4例患者均为女性,平均年龄54岁(51～61岁),2例表现为咳嗽,2例为体检发现肺结节。术后均未予特殊治疗,随访4～6年,均无复发或转移。镜下肿瘤细胞由上皮样细胞及梭形细胞构成,排列呈漩涡状,无核分裂象。免疫表型:肿瘤细胞EMA及vimentin均阳性,1例PR阳性,CK、S-100、HMB-45、Syn、Cg A、NSE、CD34、SMA均阴性。结论 PPM是极其罕见的肿瘤,根据其组织学形态及免疫表型不难诊断,应该首先排除中枢神经系统脑膜瘤的转移并对其进行鉴别诊断。PPM大多数为良性,只需外科手术切除后随访。To discuss the clinicopathological features of primary pulmonary meningioma(PPM)and the key features of the diagnosis and differential diagnosis.Methods Four cases of PPM were studied by HE staining and immunohistochemical techniques,with review of related literature.Results The four patients were female,the average age was 54 years(51-61 years).2 cases presented with cough,the other two cases showed the pulmonary nodules by CT examination.None of them received other treatments after operation.The four cases were followed up for 4 years to 6 years,and none of them recurred or metastasized.Microscopically,the tumor were composed of epithelial cells and spindle cells,which were arranged in whorls.Mitosis was absent.Immunohistochemically,the vast majority of spindle cells were immunoreactive for cytoplasmic vimentin and the cells within the whorls exhibited both cytoplasmic and membrane staining for immunoreactive EMA.One case stained positive for PR(1/4).There was no staining for CK,S-100,HMB-45,Syn,CgA,NSE,CD34 and SMA.Conclusion Primary pulmonary meningioma is a rare tumor,and it is not difficult for the diagnosis according to their histological morphology and immunophenotype.We should exclude the metastasis of the meningioma of the central nervous system and other differential diagnosis of PPM.The majority of PPM are benign,and the patients just need follow-up after surgical resection.

关 键 词：肺肿瘤 原发性 脑膜瘤 

分 类 号：R734.2[医药卫生—肿瘤]