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1、∀32∀临床与实验病理学杂志JClinExpPathol2006Feb;22(1)肺上皮样血管内皮瘤的临床病理观察顾莹莹,刘芳,曾庆思,刘慕嫦摘要:目的探讨肺上皮样血管内皮瘤(pulmonaryepithelioidhemangioendothelioma,PEH)的临床病理特征、诊断及鉴别诊断。方法对3例PEH进行光镜观察和免疫组化标记,并结合文献进行分析。结果镜下见肿瘤细胞具有上皮样或组织细胞样形态,瘤细胞为圆形或多角形,呈小巢状、索状甚至腺样结构或不规则状,分布于黏液间质中;间质可见少量黏液样变或玻璃样变;瘤细胞内含有原始血管腔,核分裂象、多形性及坏死少见。肿瘤细胞表达C
2、D34、FRAg、CD31等血管内皮细胞标记,部分病例同时表达CK和(或)Vim。结论PEH是一种低度恶性肿瘤,其病理形态具有一定的特征性,诊断时需要与肺转移癌、肺上皮样血管肉瘤、肺淋巴管肌瘤病鉴别。关键词:肺肿瘤;肺上皮样血管内皮瘤;临床病理;免疫组织化学中图分类号:R734.2文献标识码:A文章编号:1001-7399(2006)01-0032-04ClincopathologicstudyonpulmonaryepithelioidhemangioendotheliomaGUYingying,LIUFang,ZENGQings,iLIUMuchang(Departmen
3、tofPathology,theFirstAffiliatedHospitalofGuangzhouMedicalCollege,Guangzhou510120,China)Abstract:PurposeTostudytheclincopathologicmorphologicalcharacteranddiagnosisanddifferentialdiagnosisofpulmonaryepithelioidhemangioendothelioma(PEH).MethodsThreecasesofPEHwereinvestigatedwithroutinehistologican
4、dimmunohistochemicalstaining,togetherwithreviewoftheliterature.ResultsTumorcellswereepithelioid!orhistiocytoid!;roundedorpolygonaltumorcellsarrangedinnests,cords,glandulosefeatureandirregularpatterns;thetumorcellswereembeddedinmyxoidorhyalinematrix.Primitivelumenformationwithinasingletumorcell(intr
5、acytoplasmiclumens);Thekindoftumorlacksofmitoticactivity,pleomorphism,andnecrosis;Immunohistochemicalanalysisshowedthatthetumorcellsexpressedsensitivemarkersofvascularendothelialcells,suchasCD34,factorandCD31.Expressionofcytokeratinandvimentinwerealsodetectedinsomecases.ConclusionsPEHisadistincti
6、velowgradesarcomawhichhasdistinctivehistopathologicfeatures,butitshouldbedifferentiatedfrommetastaticcancerwithinlung,pulmonaryeptheloidhemangiosarcomaandpulmonarylymphangioleiomyomatosis.Keywords:lungneoplasms;pulmonaryepithelioidhemangioendothelioma;clincopathology;immunohistochemistry肺上皮样血管内皮瘤(
7、pulmonaryepithelioidhe余;7年前曾发现右中叶肺结核!,经抗结核治疗稍mangioendothelioma,PEH)是发生在肺部一种少见低好转,但X线及CT检查仍见右中下肺叶肿物;临床度恶性血管源性肿瘤,国内外文献报道不足10例。诊断为右中下肺肿物性质待查,术中冷冻切片诊断广州医学院第一附属医院1996年9月~2004年11为肺腺癌!。例2,女性,24岁,反复咳嗽、咯血1月收
