14例肝血管平滑肌脂肪瘤病理形态分析

Morphologic analysis of 14 cases of hepatic angiomyolipoma

目的 观察肝血管平滑肌脂肪瘤 (HAML)的形态学特点。方法 采用HE切片、PAS糖原和免疫组织化学SP法染色、电镜观察等对本院 10例及会诊 4例HAML进行研究。结果 14例HAML均显示肿瘤细胞围绕血管呈上皮样排列 ,血管分厚壁及薄壁 2种 ,上皮样细胞分为 4种形态 ,形态与免疫表型有一定相关关系 ,部分上皮样细胞胞质PAS阳性且抗淀粉酶消化 ,电镜下可见类似前黑色素小体及密体。结论 肌动蛋白、HMB45阳性是HAML的特殊表现 ,因其特殊的光镜及电镜下组织形态、免疫组织化学特点及其临床特征而将HAML归入血管周上皮样细胞相关肿瘤。

Objective To study the morphology of hepatic angiomyolipoma (HAML). Methods HE staining, PAS staining, immunohistochemistry and electronic microscopy were used to study 10 cases from our department and 4 cases from consultation. Results All 14 HAML cases showed perivascular epithelioid cells (PEC) with 4 different types of morphology. They presented characteristic PAS positivity premelanosome like structures and dense body under electronic microscopy. Immunohistochemistry demonstrated positive reaction for both actin and HMB45. Conclusion Light and electronmicroscopic features and immunophenotype of HAML are characteristic of PEC related lesion.