肺透明细胞瘤临床特征分析  

Analysis of clinical features of lung clear cell tumor

作　　者：韩国敬[1] 李晟姝 张歆刚[1] 刘有[3] 樊茹[1] Han Guojing;Li Shengshu;Zhang Xingang;Liu You;Fan Ru(Department of Respiratory Medicine^First Medical Center of PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心呼吸内科,北京100853 [2]解放军总医院海南医院呼吸科 [3]解放军总医院海南医院病理科

出　　处：《北京医学》2021年第8期725-729,共5页Beijing Medical Journal

摘　　要：目的探讨肺透明细胞瘤的临床特征、影像学表现及病理特征,以提高临床诊治水平。方法收集2010年1月至2020年10月解放军总医院第一医学中心诊治的6例肺透明细胞瘤患者,总结分析其临床、病理特征及影像学表现等特点。结果6例患者年龄28~70岁,平均(51.8±15.5)岁。2例胸痛,4例无症状。胸部CT可见圆形或类圆形结节影,与周围组织边界清楚,未见分叶及毛刺,未见空洞及坏死;部分伴钙化;5例(83.3%)为一侧单发,1例为左下肺多发。5例行肺叶或病灶切除后明确诊断,1例经CT引导下穿刺明确诊断。病理特征:细胞质透明,其内包含许多糖原颗粒,见肥大、短、多边形和纺锤形细胞,具有独特的细胞边界和轻度多形的核;周围有大小不等薄壁血管包围,未见坏死和有丝分裂。免疫组化:PAS(+),33.3%HMB45(+),50%Melan-A(+),16.7%S-100(+),66.7%CD34(+)。6例均手术切除,随访截至2021年1月,均无复发或转移。结论肺透明细胞瘤是良性肿瘤,组织发生尚不明确,需结合病理及免疫组化鉴别,完整的手术切除仍是最佳的治疗选择,且应长期随访。Objective To investigate the clinical features,imaging and pathological features of lung clear cell tumors.Methods Six patients with lung clear cell tumor diagnosed and treated in First Medical Center of PLA General Hospital from January 2010 to October 2020 were collected,and their clinical,pathological and imaging features were summarized and analyzed.Results The average age of the six cases was(51.8±15.5)years(28-70 years).Two cases had chest pain and four cases were asymptomatic.Chest CT showed round or round-like nodules,with clear boundaries with surrounding tissues,no lobes,burrs,cavities or necrosis were seen,some of which were accompanied by calcification-Five cases(83.3%)were single on one side,one case was multiple in the left lower lung.The diagnosis was confirmed after resection of lung lobes or lesions in five cases,and puncture under CT guidance in one case.Pathological examination showed that the cytoplasm was transparent and contained many glycogen particles,such as polygonal and spindle-shaped cells,with unique cell boundaries and mildly polymorphic nuclei in tumor cells.Surrounded by thin-walled blood vessels of various sizes,there was no necrosis or mitosis.Immunohistochemistry showed that PAS(+),33.3%HMB45(+),50%Melan-A(+),16.7%S-100(+),66.7%CD34(+).All six cases were surgically removed,and no recurrence or metastasis was found during follow-up.Conclusions Lung clear cell tumor is a benign tumor.The histogenesis is still unclear.It needs to be further differentiated by pathology and immunohistochemistry.Complete surgical resection is still the best treatment option,and long-term follow-up is required.

关 键 词：透明细胞瘤 糖瘤 良性肿瘤 

分 类 号：R734.2[医药卫生—肿瘤]