摘要
目的:探讨骨上皮样血管瘤的临床病理特征、免疫组化表达以及诊断和鉴别诊断。方法:对3例骨上皮样血管瘤进行临床资料分析、光镜观察和免疫组织化学检测,并结合文献复习进行讨论。结果:患者男1例,女2例,发病年龄22～57岁,平均38岁。3例病变部位均为下肢。最常见的临床症状是局部疼痛。X 线表现为溶骨性骨破坏,1例伴有病理性骨折。组织形态学是以内衬上皮样细胞的毛细血管型小血管的增生和以嗜酸性白细胞、淋巴细胞为主的炎细胞浸润为特征。3例肿瘤均表达 Vimentin、FⅦRAg 和 CD34。随访结果2例未见肿瘤复发,1例失访。结论:原发于骨的上皮样血管瘤是较少见良性血管源性肿瘤,其组织形态学要与骨上皮样血管内皮瘤、上皮样血管肉瘤、转移性癌以及慢性骨髓炎等鉴别,并且本病与 Kimura 病应是不同的两个疾病。
Objective:To explore the clinicopathologie features and immunohistochemical expression of epithelioid hemangioma(EH)of bone.Methods:Three cases of EH of bone were analyzed by means of clinicopathologic data,histopathologie features,immunohistochemical technique and review of the litera- ture.Results:One patient was male,two were female and their ages at presentation ranged from 22 to 57 years,with a mean of 38 years.The lesions were located in the lower limbs .The most common presenting symptom was localized pain.Radiographs showed a well-defined osteolytic lesion in 3 cases in which one case with pathologic fracture.Microscopically the distinctive features were small caliber capillaries lined by prominent epitheliOid endothelial cells proliferations and varying degrees of lymphocytes and eosi- nophils infiltrate.Immunohistoehemieally all the tumors reacted positively with vimentin F Ⅶ RAg and CD34.The follow-up data showed that there was no recurrence in 2 cases and 1 case was lost follow-up.- Conclusion:EH of bone is a rare type of benign angiomatous tumor and the differential diagnosis of EH of bone includes epithelioid haemangioendothelioma,epithelioid angiosarcoma ,metastatic carcinoma and chronic osteomyelitis.EH and Kimura's disease should be considered different entities.
