非典型性富于细胞的绒毛膜血管瘤临床病理分析

Clinical pathological analysis and literature review of atypical cellular chorangioma

目的探讨非典型性富于细胞的绒毛膜血管瘤的临床病理特征。方法通过免疫组化染色，对1例非典型性富于细胞的绒毛膜血管瘤的病理学特点进行观察，并进行文献复习。结果结节状肿物2个，大小分别为3．5cm×2．3cm×1．6cm，2．3cm×1．5cm×1cm，有包膜，切面灰红、质软。光镜特点：肿瘤呈结节状分布，肿瘤表面局灶被覆滋养叶细胞，部分区域呈典型的毛细血管瘤样结构，细胞直接形成血管腔隙，内可见红细胞成分，部分细胞丰富，呈上皮样，轻度异型，生长活跃，核分裂象易见。免疫组化：肿瘤细胞CD31、CD34、Fli-1、角蛋白18均阳性，角蛋白、雌激素受体、孕激素受体、抑制素、CD10、结蛋白、钙结合蛋白、人绒毛膜促性腺激素均阴性；表面被覆的滋养叶细胞：CK18、人绒毛膜促性腺激素阳性。结论非典型性富于细胞的绒毛膜血管瘤是一种非常少见的肿瘤，在胎盘肿瘤的鉴别诊断中应考虑该病。

Objective To explore the clinical pathological characteristics of atypical cellular chorangioma （ACC）. Methods The clinical pathological data and immunohistochemistry were investigated in 1 patient with atypical cellular chorangioma and relevant literatures were reviewed. Results The patient was 33 years old. The tumor consisted of two nodular mass which were 3.5 cm×2.3 cm ×1.6 cm and 2.3 cm×1.5 cm×1 cm. The tumor borderline was clear and section was grey-red. Histologically the tumor showed nodular pattern and was covered by trophoblastic cell. A small area of the tumor showed an typical capillary hemangioma pattern and other area showed epithelioid cell with mild dysplasia and active mitotic figure. Immunoehemieally, the tumor ceils showed positive for CD31, CD34, Fli-1, CK-18 and Vimentin, but was negative for CK, ER, PR, inhibin, CD10, desmin, Caldesmon and h-CG. The trophoblastic cells on the surface of the tumor revealed positive for CK18 and h-CG. Conclusion ACC is a rare type of tumor and no reports have ever been found in China.