动脉内膜肉瘤1例并文献复习

Artery Intimal Sarcoma:A Case Report andLiterature Review

目的探讨动脉内膜肉瘤的临床病理特征、免疫表型及鉴别诊断。方法对1例发生在肺动脉腔内并肺转移的肺动脉内膜肉瘤进行临床资料的总结、HE和免疫组化染色,观察其形态学及免疫表型特点,并复习相关文献。结果患者为中老年男性,肺部CT示左肺上叶上舌段占位伴两肺多发结节灶,镜下见肿瘤围绕血管或在血管腔内生长,部分形成不规则腔隙样结构,瘤细胞呈梭形或椭圆形,部分有核仁,胞浆丰富,红染,部分有空泡。免疫组化Vmentin弥漫阳性,SMA局灶阳性。结论动脉内膜肉瘤是发生于内膜罕见的恶性肿瘤,可能起源内膜下的多功能干细胞,IS多为高级别的未分化肉瘤,可向多种方向分化;特定的发病部位结合形态学诊断并不困难。

Objective To investigate the clinicopathological characteristics,immunophenotype and differential diagnosis of artery intimal sarcoma.Methods The clinical data of a case of pulmonary artery intimal sarcoma with pulmonary metastasis in the pulmonary artery cavity were summarized,HE and immunohistochemical staining were performed,the morphological and immunophenotypic characteristics were observed,and the related literature was reviewed.Results The patient was a middle-aged and elderly male.The lung CT showed that the upper tongue segment of the left upper lobe was occupied with multiple nodules in both lungs.Microscopically,the tumor grew around the blood vessels or in the vascular lumen,and some of them formed irregular lacunar like structures.The tumor cells were spindle or oval,some had nucleoli,rich cytoplasm,red staining,and some had vacuoles.Immunohistochemistry showed diffuse positive Vmentin and focal positive SMA.Conclusion Artery intimal sarcoma is a rare malignant tumor occurring in the intima,which may originate from multifunctional stem cells under the intima;It is not difficult to diagnose the specific location of the disease combined with morphology.