肺血管球瘤3例临床病理观察

Features of pulmonary glomus tumor:clinical and pathological analyses of three cases

目的探讨肺血管球瘤（GT）的临床病理特征、免疫组化表型及鉴别诊断。方法分析3例外科治疗的肺血管球瘤患者临床病理和影像学检查资料,对手术切除的肿瘤标本进行常规病理组织学和免疫组化检查,并复习相关文献,探讨其临床病理特征。结果 3例患者中,男性2例,女性1例,年龄42~58岁。组织学上,肿瘤组织由小血管及周围的肿瘤细胞组成,瘤细胞丰富,圆形、卵圆形,形态较一致,胞质丰富红染或透亮,无明显异型性和核分裂象,间质明显黏液变性、水肿。免疫组化染色示瘤细胞vimentin、SMA（＋）,Cg A、Syn、CD34、CD99、HMB45和CK（-）。结论肺血管球瘤非常罕见,临床表现为肺内占位性病变的相关症状或体征,该肿瘤的诊断依赖病理组织学及免疫组化检查,预后较好。

Objective To investigate the clinicopathologic features,immunohistochemical stain,diagnosis and differential diagnosis of pulmonary glomus tumor.Methods Three cases of pulmonary glomus tumor were studied by hematoxylineosin staining,cytochemical and the immunohistochemical staining and the clinicopathologic features,imaging data were analyzed with review of the literature.Results Of the 3 patients,2 were male and 1 was female,aged 42-58 years.Histologically,the tumor tissue was composed of small blood vessels surrounding the tumor cells;tumor cells showed round,oval,relatively uniform nuclei in appearance,abundant cytoplasm stained red or bright,no obvious atypia and mitosis,and obvious interstitial mucoid degeneration and edema.The expression of vimentin and SMA was detected;Cg A,Syn,CD34,CD99,CK and HMB45 were not expressed by immunohistochemical staining.Conclusion Primary pulmonary glomus tumor is rare.The clinical manifestation is associated with intrapulmonary lesions or signs;diagnosis of the tumor depends on pathological and immunohistochemical examination and the prognosis is very good.