分叶状毛细血管瘤57例临床病理分析

Lobular capillary hemangioma: a clinicopathological analisis of 57 cases and review of literature

目的观察分叶状毛细血管瘤的临床病理学特点。方法采用HE染色技术对57例分叶状毛细血管瘤进行观察,收集相关临床病理资料,并进行文献复习。结果肿瘤呈单发息肉状,主要发生于头面部和手部,直径多<2 cm,无性别差异。病变大多位于黏膜或真皮内,其中2例位于静脉内,由增生的毛细血管形成小叶状结构,部分表面有溃疡形成或出血。免疫组化:血管内皮细胞FⅧ、CD31、CD34及SMA、诱导型一氧化氮合酶(iNOS)、内皮细胞酪氨酸激酶受体Tie-2(+)。结论分叶状毛细血管瘤主要发生在成人,可自愈,部分复发。组织学特征是毛细血管瘤样增生形成小叶状结构,需与包括血管内皮瘤、血管肉瘤在内的多种血管病变鉴别。

Objective To study the clinicopathological features of the lobular capillary hemangioma （LCH）. Methods 57 cases of LCH were analyzed with hemotoxylin-eosin stain and the clinicopathological data collected. Results The tumors showed single polypoid shape and mostly occured at the head, face and hand, but two cases occursed within vein. There was no sexual difference in this group. Usually, the size of tumor was less than 2 cm. Microscopically, LCHs were composed of lobnlar structures that consisted of proliferating capillaries in mucosa and derma. Ulcer and haemorrhage could be observed in some cases.Immunohistochemically, the tumor cells were positive for FⅧ, CD31, CD34 and SMA, inducible NO synthase （iNOS）, and endothelial receptor tyrosine kinase Tie-2. Conclusions Lobular capillary hemangioma is a benign tumor, mainly occurs in adult and some cases can recur. The etiology is not clear. Histologically, the chief feature is the lobular structure composed of proliferating capillaries. The lesion should be differentiated from other vascular proliferative lesions, including angiosarcoma.