骨髓细胞形态学检查诊断上皮样血管内皮细胞瘤1例  

A case of epithelioid hemangioendothelioma diagnosed by bone marrow cell morphology

作　　者：罗丽卿[1] 曹守燕[2] 初文慧 彭振翼[3] Luo Liqing;Cao Shouyan;Chu Wenhui;Peng Zhenyi(Department of Hematology,Binzhou Medical University Hospital,Binzhou 256603,China;Department of Gynaecology and Obstetrics,Binzhou Medical University Hospital,Binzhou 256603,China;Department of Thyroid Surgery,Binzhou Medical University Hospital,Binzhou 256603,China)

机构地区：[1]滨州医学院附属医院血液科,滨州256603 [2]滨州医学院附属医院妇产科,滨州256603 [3]滨州医学院附属医院甲状腺外科,滨州256603

出　　处：《中华检验医学杂志》2022年第5期549-552,共4页Chinese Journal of Laboratory Medicine

摘　　要：上皮样血管内皮瘤(EHE)是一种罕见的恶性血管肿瘤,其恶性程度介于完全良性的血管瘤和高度恶性的血管肉瘤之间,起源于血管内皮细胞或前内皮细胞,以上皮样或组织细胞样外观的血管内皮细胞增殖为特征。EHE在所有血管肿瘤中发病率<1%,可发生于身体多个部位,最常发生于肝脏,其次是肝和肺同时受累、肺单独受累、骨单独受累。目前在国内未见报道通过骨髓细胞形态学检查诊断EHE的病例。该患者通过骨髓细胞形态学检查发现异常细胞,指引临床下一步诊疗方向,最终诊断为EHE,骨髓细胞形态学检查为临床进一步诊疗提供重要依据。上皮样血管内皮细胞瘤需要与多种良恶性血管源性肿瘤相鉴别,尤其与其他类型的上皮样血管源性肿瘤鉴别困难。目前已经发现该病有特征性的细胞遗传学和分子生物学异常,结合病理组织学形态和免疫组织化学检查,综合考虑可以做出诊断与鉴别诊断。Epithelioid hemangioendothelioma(EHE)is a rare malignant vascular tumor.Its malignancy is between benign hemangioma and highly malignant angiosarcoma.It originates from vascular endothelial cells or pre-endothelial cells.It is characterized by the proliferation of vascular endothelial cells with a skin-like or histiocyte-like appearance.The incidence of EHE is less than 1%in all vascular tumors,and it can occur in multiple parts of the body,most often in the liver,followed by simultaneous involvement of the liver and lung,the lung alone,and the bone alone.At present,there is no report of epithelioid hemangioendothelioma diagnosed by bone marrow cell morphological examination in China.In this case,abnormal cells were found through bone marrow cell morphological examination,which guided the direction of further diagnosis and treatment.And finally the patient was diagnosed as epithelioid hemangioendothelioma.The bone marrow cell morphological examination can provided an important basis for clinical diagnosis and treatment.Epithelioid hemangioendothelioma needs to be differentiated from a variety of benign and malignant angiogenic tumors,especially other types of epithelioid angiogenic tumors.At present,it has been found that the disease has characters of cytogenetic and molecular biological abnormalities.Combined with histopathological morphology and immunohistochemical examination,we can make the diagnosis and differential diagnosis.

关 键 词：上皮样血管内皮瘤 骨髓细胞形态学 诊断 

分 类 号：R732.2[医药卫生—肿瘤]