肺罕见良性双相分化性肿瘤——肺腺纤维瘤1例并文献复习
发布时间：2019-07-19 09:29
【摘要】：肺腺纤维瘤(pulmonary adenofibroma)是一种非常罕见的肺原发性上皮与间质双相分化的良性肿瘤,多为胸膜下的实性界清结节,上皮呈简单的腺样结构,偶有乳头或叶状结构,上皮周围围绕着丰富的间质,间质由温和的梭形细胞及胶原组成。在目前有限的病例报道中,尚未发现与肿瘤相关的复发与转移。由于既往报道极少,对此类疾病的认识不足,在冰冻组织病理诊断或穿刺组织病理诊断中,容易将其误诊为恶性病变。本文报道1例肺腺纤维瘤,患者为74岁女性,体检时发现左肺外周型肿物,近年缓慢增大,遂于胸腔镜下行肺叶楔形切除手术。肉眼观肿物呈类圆形,边界清晰,但无明显包膜,切面灰白质韧。显微镜下肿瘤由结构简单的腺样分化的上皮及形态温和的梭形细胞间质两种成分组成,每个间质细胞周围围绕着粗细不一的胶原束,偶见小的粗乳头状或叶状结构。免疫组织化学染色显示腺上皮与肺泡上皮表型一致,间质细胞CD34、B淋巴细胞瘤-2(B-cell lymphoma-2,Bcl-2)、CD99和雌激素受体(estrogen receptor,ER)阳性,S-100、平滑肌肌动蛋白(smooth muscle actin,SMA)以及间皮标记等均为阴性。短期随访患者无复发或转移表现。本文回顾了国内外已报道的相关病例,并对肺腺纤维瘤可能的组织学起源进行初步探讨。
[Abstract]:Pulmonary adenofibroma (pulmonary adenofibroma) is a very rare benign tumor with biphasic differentiation between primary epithelial and stroma of the lung. Most of them are solid borderline nodules under pleura. The epithelial cells have simple adenoid structure and occasionally papilla or leaflike structure. The stroma is surrounded by abundant stroma, and the stroma is composed of mild fusiform cells and collagen. In the current limited case reports, no tumor-related recurrence and metastasis has been found. Because there are few reports in the past and there is not enough understanding of this kind of disease, it is easy to misdiagnose it as malignant lesion in the pathological diagnosis of frozen tissue or puncture tissue. This paper reports a case of pulmonary adenofibroma, a 74-year-old female. The peripheral mass of the left lung was found during physical examination, which increased slowly in recent years and was resected by thoracoscopy. The masses were round, with clear boundary, but no obvious envelope, and the section was gray and white matter tough. Under microscope, the tumor is composed of simple adenoid differentiated epithelial cells and mild fusiform cell stroma. Each stroma cell is surrounded by collagen bundles of different thickness, and occasionally has a small thick papilla or leaflike structure. Immunohistochemical staining showed that the phenotype of adenoepithelial cells was the same as that of alveolar epithelial cells, but the positive rates of CD34,B lymphocytoma-2 (B-cell lymphoma-2,Bcl-2), CD99 and estrogen receptor (estrogen receptor,ER), S 鈮，
本文编号：2516224
[Abstract]:Pulmonary adenofibroma (pulmonary adenofibroma) is a very rare benign tumor with biphasic differentiation between primary epithelial and stroma of the lung. Most of them are solid borderline nodules under pleura. The epithelial cells have simple adenoid structure and occasionally papilla or leaflike structure. The stroma is surrounded by abundant stroma, and the stroma is composed of mild fusiform cells and collagen. In the current limited case reports, no tumor-related recurrence and metastasis has been found. Because there are few reports in the past and there is not enough understanding of this kind of disease, it is easy to misdiagnose it as malignant lesion in the pathological diagnosis of frozen tissue or puncture tissue. This paper reports a case of pulmonary adenofibroma, a 74-year-old female. The peripheral mass of the left lung was found during physical examination, which increased slowly in recent years and was resected by thoracoscopy. The masses were round, with clear boundary, but no obvious envelope, and the section was gray and white matter tough. Under microscope, the tumor is composed of simple adenoid differentiated epithelial cells and mild fusiform cell stroma. Each stroma cell is surrounded by collagen bundles of different thickness, and occasionally has a small thick papilla or leaflike structure. Immunohistochemical staining showed that the phenotype of adenoepithelial cells was the same as that of alveolar epithelial cells, but the positive rates of CD34,B lymphocytoma-2 (B-cell lymphoma-2,Bcl-2), CD99 and estrogen receptor (estrogen receptor,ER), S 鈮，
本文编号：2516224
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