肺血管肉瘤的临床病理观察

Clinical and pathologic characteristics of primary angiosarcoma in the lung

目的探讨肺原发性血管肉瘤的临床病理特点。方法对我院收治的1例,发生于肺的血管肉瘤的临床表现、组织形态学及免疫组化进行分析,并复习相关文献。结果患者男性,67岁,临床表现主要为咳嗽和痰中带血。光镜下上皮样或梭形肿瘤细胞形成不规则且相互吻合的血管腔隙,伴大片的出血坏死。免疫组织化学染色显示肿瘤细胞CD34、CD31和vim阳性;CK(AE1/AE3)、TTF-1和S-100阴性。结论原发性肺血管肉瘤具有和其他部位血管肉瘤相似的组织形态学特点,免疫组织化学是其必要的辅诊手段。其临床表现无明显特异性,早期诊断困难。

Objective To research the clinical pathological features of primary angiosarcoma in the lung. Methods The clinical manifestations, histopathologieal features and immunohistoehemical results were analyzed in one case of primary angiosarcoma in the lung, with review of the related literatures. Results The patient was a 67 year-old man, having cough and bloody sputum. Microscopically, the lesion was consisted of a number of spindle cells and epithelial cells, with extensive areas of necrosis and haemorrhage. These tumor cells formed rudimentary vascular channels and these neoplastic channels were irregular in shape. Immunohistochemically, these tumor cells were positive for CD31, CD34 and vim; negative for CK（AE1/AE3）, TTF-1 and S-100. Conclusion Histopathological features of primary angiosarcoma in the lung are similar to angiosarcoma at other sites. Immunoeytochemical studies are essential to the diagnosis. Early diagnosis is difficult because of nonspecific clinical symptoms.