分叶状毛细血管瘤39例临床病理分析

Lobular capillary hemangioma:a clinicopathologic study of 39 cases

目的 观察分叶状毛细血管瘤的临床与病理特点。方法 采用HE染色及免疫组化技术对 39例分叶状毛细血管瘤进行观察 ,并对 15例进行了随访。结果 肿瘤平均 0 7cm大小 ,32例 (82 1% )病变呈息肉状。肿瘤位于黏膜或真皮内 ,由增生的毛细血管形成分叶结构 ,35例 (89 7% )伴有明显的血管周梭形细胞增生 ,核分裂象易见 ,平均 7 6个 / 10HPF ,缺乏核异型性。 31例 (79 5 % )表面有溃疡形成 ,2 2例 (5 6 4 % )被复鳞状上皮呈“衣领样”增生。血管内皮细胞CD34(+) ,血管周梭形细胞SMA(+) ,前者明显少于后者。 4例 (2 6 7% )复发 ,再次手术后无复发。结论 分叶状毛细血管瘤在年龄、性别、发病部位及病程上有明显特点 ,可复发 ,但呈良性经过。组织学特征是毛细血管瘤样增生形成小叶结构 ,除内皮细胞外 ,血管周梭形细胞也参与肿瘤组成。

Objective To study the clinicopathologic features of the lobular capillary hemangioma. Methods Lobular capillary hemangiomas of 39 cases were analysized with hemotoxylin-eosin stain and immunohistochemical technique and 15 patients were followed up. Results The tumors were with mean size of 0.7?cm. The lesions showed polypoid shape in 32 cases (82.1%).The tumors composed of lobular structures consisted of proliferating capillaries in mucosa and derma, and prominent proliferation of peri vascular spindle cells could be seen in 35 cases (89.7%). The mitotic figures (mean 7.6 /10HPF) were eosily observed. The ulcers and the epithelial collarette hyperplasia could be observed in 31 cases (79.5%) and 22 cases (56.4%) respectively. Immunohistochemically, endothelial cells expressed CD34 and peri-vascular spindle cells showed SMA positive; and a number of SMA (+) cells were more markedly than CD34 (+) cells. The recurrent rate in 4 cases was 26.7%, and no recurrence was followed after second operation. Conclusions Lobular capillary hemangioma has evident charateristics in age, sex, site and lesion duration. The clinical course is benign, though some cases can recur. Histologically, the chief feature is lobular structure composed of proliferating capillaries. Except endothelial cells, the peri-vascular spindle cells are also important elements of the tumor.