2例原发性肺淋巴上皮瘤样癌临床病理特征分析  被引量:2

Analysis of clinicopathological features of 2 cases of primary lymphoepithelioma-like carcinoma of the lung

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作  者:刘爱凤[1] 王志敢[1] 罗海军[1] 朱德茂[1] 聂长庆[2] LIU Aifeng;WANG Zhigan;LUO Haijun;ZHU Demao;NIE Changqing(Department of Pathology,Changsha Centrorl Hospital,Changsha,Hunan,410004,China;Department of Pathology,the First People's Hospital of Changde City,Changde,Hunan,415003,China)

机构地区:[1]长沙市中心医院病理科,湖南长沙410004 [2]常德市第一人民医院病理科,湖南常德415003

出  处:《当代医学》2022年第15期12-15,共4页Contemporary Medicine

摘  要:目的分析肺淋巴上皮瘤样癌(LELC)的临床病理学特征、诊断及鉴别诊断,以提高临床诊断准确性。方法分析2019年4—9月长沙市中心医院诊治的2例肺LELC临床病理特征,复阅全部苏木精-伊红(HE)切片及免疫组化切片,复习相关文献。结果2例肺LELC镜下形态表现类似,低倍镜下肿瘤边界较清晰,呈推挤样及浸润性生长。高倍下肿瘤细胞体积大,胞界不清,细胞质丰富、淡染,胞核呈空泡状,核仁明显。患者2部分区域肿瘤细胞实性成片,排列紧密,淋巴细胞稀少,表现出非经典病理形态。免疫标记表达一致,肿瘤细胞细胞角蛋白(CK)、P40、P63、细胞角蛋白5(CK5)表达均为阳性,甲状腺转录因子-1(TTF1)、新天冬氨酸蛋白酶A(Napsin A)、CD56、嗜铬素A(CgA)、突触素(Syn)表达均为阴性。EB病毒编码的小RNA(EBER)均阳性。结论肺LELC相对罕见,病理医师需仔细观察其形态学特征,注意鉴别诊断,合理应用免疫标记,并完善EBER检测,可获得正确诊断。Objective To analyze the clinicopathological features,diagnosis and differential diagnosis of primary pulmonary lymphaeoepithelioma-like carcinoma(LELC),in orderto improve the accuracy of clinical diagnosis.Methods The clinicopathological features of 2 cases of pulmonary LELC diagnosed and treated in Changsha Central Hospital from April to September 2019 were analyzed.All hematoxylin eosin(HE)sections and immunohistochemical sections were reviewed,and the relevant literature was reviewed.Results The morphology of the 2 cases of pulmonary LELC were mostly similar under microscope.At low magnification,the tumor boundary is clear,showing justle-like and infiltrative growth with clear boundary.At high magnification,the tumor cells are large,unclear cell boundary,rich in cytoplasm and light stained,with vacuolated nuclei and distinct nucleoli.In case 2,part of the tumor cells were solid and patchy,closely arranged,with few lymphocytes,showing nonclassical pathological morphology.The expression of cytokeratin(CK),P40,P63 and cytokeratin5(CK5)in tumor cells were positive,while the expression of thyroid transcription factor-1(TTF1),novel aspartic proteinase A(Napsin A),CD56,Chromogranin A(CgA)and synaptophysi(Syn)were negative.Epstein-Barr virus-encoded small RNA(EBER)were all positive.Conclusion Primary pulmonary lymphaeoepithelioma-like carcinoma is relatively rare.Pathologists need to carefully observe its morphological characteristics,pay attention to differential diagnosis,reasonably apply immune markers,and EBER detection,so as to obtain correct diagnosis.

关 键 词:肺癌 淋巴上皮瘤样癌 EB病毒编码的小RNA 

分 类 号:R734.2[医药卫生—肿瘤]

 

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