肺硬化性血管瘤43例临床病理分析

Sclerosing hemangioma of the lung: a clinicopathologic study of 43 cases

目的 探讨肺硬化性血管瘤 (SHL)的临床病理特点和组织发生。方法 对 43例经外科手术切除的SHL临床和病理资料进行回顾性分析和随访 ,1 5例进行TTF 1、EMA ,vimentin ,CK(AE1 /AE3)、CK7、CK5/6、S 1 0 0、NSE、Syn、CgA、NF、CD34、Ⅷ因子和SMA免疫组化研究。结果 组织学以瘤细胞形成混合型结构为主要表现 ,2 3 3 %有周围肺泡 /和呼吸上皮浸润 ;立方细胞和多角形细胞共同表达TTF 1和EMA ,AE1 /AE3和CK7仅在立方细胞中表达 ,2例局部散在表达CgA ;随访 39例 ,除 1例再发外余无转移和复发。结论 SHL可能起源于幼稚的呼吸上皮 ,以乳突和实体结构形成为主者应与腺瘤和典型类癌鉴别。部分肿瘤有侵袭性生长的倾向 ,外科手术治疗宜行瘤切除而非肿块剥离。

Objective To investigate the clinicopathologic features and histogenesis of sclerosing hemangioma of the lung(SHL) Methods The clinicopathologic data of 43 cases with SHL were reviewed retrospectively, and the follow up was performed in 39 patients 15 cases of them were immunostained with a panel of antibodies including thyroid transcription factor 1 (TTF 1), epithelial membrane antigen (EMA), pancytokeratin (AE1/AE3), and vimentin Results The main histologic appearance was mixed structure with solid, papillary, hemorrhagic and sclerotic paterns. 23.3% of the tumors had infiltration of peripheral alveoli/or respiratory epithelium. Both surface lining cuboidal cells and pale polygonal cells stained with TTF 1 and EMA,and both AE1/AE3 and CK7 were only positive in surface lining cuboidal sells The follow up time of 39 cases One case had recurrence. Conclusions SHL is derived from primitive respiratory epithelium Those SHL with papillary and solid structures as main histologic appearance should be differentiated from adenoma and typical carcinoid Some tumors have a trend of invasive growth, which indicates that these tumors should be removed and avoid to be detached