微静脉型血管瘤1例临床病理观察并文献复习

Clinicopathological observation of microvenular hemangioma:a case report with review of the literature

目的 :探讨微静脉型血管瘤的形态学特征和免疫组化表型 ,侧重于病理诊断和鉴别诊断。方法 :对 1例微静脉型血管瘤进行临床病理学分析和免疫组织化学研究。结果 :肿瘤由不规则分枝状的增生性薄壁血管组成 ,增生性的血管在真皮的全层内呈浸润性生长。部分内皮细胞略肿胀 ,但细胞无异型性 ,也无核分裂象。多数血管内皮细胞的外围可见梭形的血管周细胞。血管之间的基质伴有不同程度的胶原样变性。免疫组化标记显示内皮细胞强阳性表达CD31、CD34和FⅧ等内皮细胞标记 ,而血管周细胞则强阳性表达α SMA和MSA。结论 :微静脉型血管瘤是一种具有独特临床病理学特征的良性血管肿瘤 ,肿瘤中的血管属于小静脉。熟悉该肿瘤的组织学特点对避免误诊为血管肉瘤和卡波西肉瘤具有重要意义。

Purpose To study the clinicopathological features and the immunophenotype of microvenular hemangioma, with emphasis on differential diagnosis. Methods One typical case of microvenular hemangioma was analyzed by light microscopy and immunohistochemistry. Results Microscopically, the tumor was composed of a proliferation of irregular branched thin wall blood vessels which showed an infiltrative pattern in the whole dermis. Some endothelial cells were mildly plump, however, cytological atypia and mitotic figures were both absent. Pericytes were discernible in most blood vessels. The stroma between the vessels exhibited a variable degree of sclerosis. Immunohistochemically, while endothelial cells showed strong immunoreactivity for CD31,CD34,and factor Ⅷ related antigen, pericytes showed strong immunoreactivity for α SMA and MSA. Conclusion Microvenular hemangioma is a distinctive benign vascular neoplasm, the neoplastic blood vessels are possibly venules. Recognizing this rare entity is important to avoid confusion with angiosarcoma or Kaposis sarcoma.