63例肺炎性假瘤临床病理分析

INFLAMMATORY PSEUDOTUMOR OF THE LUNG A CLINICOPATHOLOGICAL STUDY OF 63 CASES

目的：进一步提高对炎性假瘤的认识及诊断水平，进一步探讨本病变的性质及组织发生。方法：对６３例原诊断肺炎性假瘤的ＨＥ切片逐个进行组织学和临床病理的回顾性复习研究，结合文献资料进行了组织学分型、命名，并对其中１０例肺硬化性血管瘤应用免疫组化ＬＳＡＢ法进行了６种抗体（ＥＭＡ、ＳＭＡ、ＫＰ－１、波形蛋白、ＣｇＡ、Ｓ－１００）的检测。结果：将肺炎性假瘤分为三型：硬化性血管瘤样型；浆细胞肉芽肿型；纤维组织细胞瘤样型。炎性假瘤是一种以间质成分增生为主的混合性炎性增生。主要增生细胞为各种间质细胞、上皮细胞；神经内分泌细胞也有不同程度增生。结论：根据细胞成分的多样性、生长方式上无包膜以及生物学行为上具有一定的自限性均符合是炎性假瘤，而不是真性肿瘤。

Objective:In order to further improve the level of understanding and diagnosis of inflammatory pseudotumor of the lung,go further into the nature and the histogenesis of the disease.Methods:The reviewed studies in histology and clinical pathology were done to 63 cases of inflammatory pseudotumor of the lung.Which can be classified and named the disease according with some references.In 10 cases of sclerosing hemangioma of the lung,while they were tested using EMA,SMA,KP-1,Vimentin,CgA and S-100 antibodies with labelled streptavidin-biotin method (LSAB).Results:Which can be classified into three categories depending on the dominant cellular constituent and histological patten:Sclerosing hemangioma type;Plasma cell granuloma type;Fibrous histiocytoma type.We believe that the inflammatory pseudotumor is rather a kind of mixed inflammatory hyperplasia mainly containing hyperplastic stroma and many other components including various kinds of mesenchymal cells,epithelial cells and neuroendocrine cells and so on.Conclusion:This tumor is rather an inflammatory pseudotumor than a real tumor.Which can be concluded from the pleomorphism of its composition no capsule and self-restriction during the growth.