肺硬化性血管瘤120例临床病理分析

Pathological features of pulmonary sclerosing hemangioma: an analysis of 120 cases in frozen section

目的探讨肺硬化性血管瘤(pulmonary sclerosing hemangioma,PSH)的临床病理特征及免疫表型。方法收集120例PSH的临床病理资料,探讨其临床特点、组织学特征及免疫表型。结果 PSH肿块与周围肺组织界限清楚,切面多为灰棕色,常伴出血灶。镜下可见两种肿瘤细胞、四种组织结构,多以混合形式存在(92/120,76.67%),并常发现泡沫样细胞灶性聚集及肥大细胞散在分布(83/120,69.17%)。免疫表型:表面立方细胞及间质多角形细胞TTF-1、EMA阳性,表面细胞SP-A、CK、Napsin A阳性,间质细胞vimentin阳性。结论 PSH大体表现及镜下典型的"两种细胞,四种结构"组织特点是诊断PSH的重要依据,泡沫样细胞灶性聚集及肥大细胞散在分布对PSH诊断及鉴别诊断有重要提示意义。

Purpose To analyze retrospectively the clinicopahological characteristics and immuophenotype in 120 cases of pulmonary selerosing hemangioma （ PSH） . Methods Data of 120 cases of PSH were collected and reviewed, including gross features and frozen diagnosis, histopathological features, morphology in HE and immunohistochemical characteristics of tumor cells. Results PSH pres-ents a well-circumscribed mass with a sense of expansion after cutting, which showed a solid, grey to tan-yellow surface with foci of haemorrhage. Two kinds of tumor cells and four typical patterns with mixed forms, are often shown under light microscope （92/120, 76. 67%）. Focal accumulation of histocytes and scattered mast cells were noted in some cases （83/120, 69. 17%）. Both surface cells and round cells were TTF-1 and EMA positive. Surface cells expressed SP-A, CK and NapsinA. Round cells expressed vimentin. Conclusion Gross features and typical“two cell types, four patterns” contribute to PSH diagnosis. Meanwhile, foal accumulation of foam histocytes and scattered mast cells show a clue to PSH diagnosis and differential diagnosis.