肝血管平滑肌脂肪瘤临床病理分析

Clinical pathological analysis of hepatic angiomyolipoma

目的 观察肝血管平滑肌脂肪瘤(HAML)的临床及病理形态特点。方法 对3例HAML临床相关资料,采用常规处理,HE染色,特殊染色,免疫组织化学染色,进行光镜观察。结果 3例肿瘤均可见到血管、平滑肌、脂肪三种主要成分混合存在。上皮样细胞排列呈弥漫状、条索状、小梁状,其间有散在脂肪区域和薄壁血窦状血管和少量厚壁畸形血管。免疫组织化学:上皮样细胞HMB45强阳性,3例平滑肌细胞表达desmin、actin和vimentin。结论 平滑肌表达HMB45是诊断HAML的可靠依据,同时平滑肌也表达actin,desmin和vimentin。电镜下的组织形态对诊断有一定意义。

Objective To observe the clinical and pathomorphological features of hepatic angiomyolipoma (HAML). Methods Relevant clinical information of 3 cases of HAML treated by conventional managment was collected. HE staining, special staining and immunohistochernical staining of the tumor and observation by optical microscope were carried out. Results Mixed existence of blood vessels, smooth muscle and fat could be found in all 3 HAML. Tumor cells were the epithelioid cells arranged in large solid sheets, cords and trabecular patterns. There were some scattered fat areas, thin-walled vessels with shape of sinusoids as well as a few thick-walled malformed vessels. Immunohistochernical staining of epithelioid cell showed positive HMB45 test and expression of desmin, actin and vimentin in smooth muscle of 3 cases. Conclusion Expression of HMB45 in smooth muscle is a reliable base for diagnosis of HAML . At the same time smooth muscle also express actin, desmin and vimentin. The histomorphologycal result of electron microscopic examination has certain significance for diagnosis.