4 例肺上皮样血管内皮瘤临床病理研究.docVIP

精品论文 参考文献 4 例肺上皮样血管内皮瘤临床病理研究 胡 骏 刘志红 陈森林湖南省肿瘤医院/中南大学湘雅医学院附属肿瘤医院病理科 湖南长沙 410013 　　【摘 要】目的：探讨肺上皮样血管内皮瘤(pulmonary epithelioid haemangioendothelioma，PEH)的临床病理形态学特征、免疫组化表型、诊断及鉴别诊断。方法：回顾分析4 例肺穿刺活体组织检查诊断PEH 患者的病理特点、免疫组织化学检查结果、临床及实验室检查结果。结果：4 例PEH 患者年龄30-65 岁，男女比1：3，女性患者年龄均小于40 岁；影像学检查示肺内结节多考虑为转移性癌或结核等，实验室检查未见明显异常。光镜下肿瘤细胞有上皮样及空泡样形态，空泡内偶见红细胞，瘤细胞呈条索状、小巢状，腺样结构及不规则状分布于淀粉样或玻璃样变间质中，瘤细胞未见核分裂相，肿瘤边缘区细胞丰富，呈息肉或肾小球样填塞于扩张的肺泡腔。肿瘤细胞表达CD31、CD34、第Ⅷ因子相关抗原(factorⅧrelatedantigen，FⅧRAg)等血管内皮细胞标记，同时部分表达波形蛋白(vimentin)和细胞角蛋白(cytokeratin，CK)。结论：正确的诊断与鉴别诊断PEH 需要结合影像学检查、组织学观察和免疫组织化学检测等方法。 　　【关键词】肺；上皮样血管内皮瘤；病理学；免疫组化；鉴别诊断Clinical and pathological study of 4 cases of pulmonary epithelioid hemangioendotheliomaHu Jun Liu Zhihong Chen SenlinDepartment of Pathology, Cancer Hospital of Hunan Province TumorHospital Affiliated toXiangya Medical College of Central South UniversityHunan Changsha 410013[Abstract] Objective:Toinvestigatetheeffectof pulmonary epithelioidhemangioendothelioma (pulmonary epithelioid haemangioendothelioma, PEH) andtheclinical pathological characteristics and immunohistochemical phenotype, diagnosis and differential diagnosis. Methods: the clinical and laboratory analysis of 4 cases of lungpuncture biopsy for the diagnosis of PEH patients and pathological features,immunohistochemical examination results, examination results. Results: 4 cases of PEHpatients with age 30-65 years old, male to female ratio was 1:3, the age of female patients were less than 40 years old; imaging examination showed pulmonary nodules moreconsideration for metastaticcarcinoma or tuberculosis, laboratoryexamination showednoobviousabnormalities. Underlightmicroscope, tumorcells were epithelioid and vacuolarmorphology of red blood cells, even within the cavity, the tumor cells showed cord like andsmall nests, in amyloid orhyalinized stroma likedistribution ofadenoid structureandirregular, tumor cells were mitoticphase, theedgeoftumor cells, alveolar cavitywas polypor glomeruloid packing in expansion. Theexpressio