气管恶性潜能未定血管球瘤临床病理观察

Glomus tumor of bronchi with uncertain malignant potential:a clinicopathologic analysis

目的探讨气管恶性潜能未定血管球瘤的病理学特征及诊断、鉴别诊断。方法对1例气管恶性潜能未定血管球瘤的活检、术中冷冻及根治术标本进行光镜观察及免疫组化标记,并结合临床资料复习文献。结果肿瘤位于右肺上叶支气管开口处;镜下见肿瘤侵及气管黏膜层及黏膜下层,瘤细胞呈巢状分布、较一致,呈卵圆形及多角形,胞质嗜酸性到透明状,细胞核位于中央,密集围绕血管。免疫组化:肿瘤细胞vimentin和SMA(),EMA、CK、CK5、CK7、CK34BE12、TTF-1、CD31、CD34、desmin、S-100、Syn、CgA、NSE、bcl-2、ALK和GFAP均(-)。网状纤维染色示网状纤维围绕单个瘤细胞。结论发生于肺组织的血管球瘤非常罕见,活检及术中冷冻诊断困难。组织病理学特征及免疫组化标记是其主要的诊断依据。

Purpose To report the clinicopathological features of glomus tumor of bronchi with uncertain malignant potential.Methods Clinical,morphologic and immunohistochemical representations were described in one case of glomus tumor of bronchi with uncertain malignant potential.Results This lesion occurred in trachea.Histopathologically,the lesion showed smooth muscle differentiation.Histological examination revealed a sheet-like proliferation of epithelioid glomus cells.The tumor cells were immunoreactive for vimentin,smooth muscle actin.Reticular fiber enclosed every tumor cell.Conclusion Primary glomus tumors of the lung are rare.The rarity of this type of tumor makes it difficult to diagnose,especially with specimen of biopsy and frozen section.The diagnosis depends on the features of histopathology and immunohistochemistry.