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上皮样血管内皮瘤6例临床病理分析 预览 被引量:1

Clinicopathologic Analysis of 6 Cases of Epithelioid Hemangioendothelioma
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摘要 目的探讨上皮样血管内皮瘤(epithelial hemangioendothelioma,EHE)的临床病理特点、免疫学表型、诊断及鉴别诊断要点。方法搜集并分析6例EHE的临床病理学特征及免疫组织化学特点并随访,复习相关文献综合分析。结果患者男性2例,女性4例;年龄28~76岁,平均年龄56岁。肿瘤分别位于右大腿、右腕部、左肺、右股骨、第12胸椎及右胸壁。镜下示上皮样、梭形或多角形的肿瘤细胞呈条索状、小巢状排列,常可见明显的胞质内空泡,其内可见红细胞;瘤细胞胞质丰富,嗜酸性,核分裂像多少不等,间质可有不同程度黏液样变或玻璃样变,部分间质可见含铁血黄素沉积。免疫组织化学染色显示肿瘤细胞不同程度阳性表达CD34、CD31、FLI-1、CK-pan。结论EHE是一种低度恶性的血管源性肿瘤,常见于软组织、肺、骨等部位,镜下瘤细胞呈上皮样,易误诊为上皮源性肿瘤;需与原发/转移癌,上皮样血管瘤,上皮样血管肉瘤等鉴别。熟悉EHE的临床病理学特征有助于做出正确的诊断。 Objective To investigate the clinicopathologic characteristics,diagnosis and differential diagnosis of epithelial hemangioendothelioma(EHE).Methods Six cases of EHE were retrospectively analyzed,combined with literature on their clinical presentation,morphology,immunohistochemistry and prognosis.Results Cases studied included 2 males and 4 females.The age of patients ranged from 28 to 76 years(mean age 56).The tumors were located in right thigh,right wrist,left lung,right femur,the12th thoracic vertebra,right chest wall.The tumor cells were epithelioid,spindled or polygonalshaped and exhibited cord-like or small nest growth pattern.Some tumor cells formed cytoplasmic vacuoles,which contained erythrocytes.The tumor cells showed abundant eosinophilic cytoplasm,mitosis can be found.The stroma varied from highly myxoid to hyaline and some interstitial deposits of hemosiderin can be seen.Immunohistochemical study showed that the tumor cells were positive for CD34、CD31、FLI-1 and CK-pan to different extents.Conclusion EHE is a low-grade malignant vascular tumor.It is common in soft tissue and lung bone.EHE is misdiagnosed as carcinoma for its significant epithelioid morphology.A correct diagnosis needs the comprehensive evaluation of the exclusion of primary/metastatic carcinoma,hemangioma,and epithelioid angiosarcoma.
作者 方雪婷 出树强 蔡素琴 吴春林 FANG Xueting;CHU Shuqiang;CAI Suqin;WU Chunlin(Department of Pathology,The Second Affiliated Hospital of Fujian Medical University,Quanzhou Fujian 362000,China)
出处 《中国卫生标准管理》 2018年第21期108-111,共4页
关键词 上皮样血管内皮瘤 低度恶性 临床病理学 免疫组化 诊断 鉴别诊断 epithelioid hemangioendothelioma low-grade malignant clinicopathologic characteristics immunohistochemistry diagnosis differential diagnosis
作者简介 通信作者:吴春林。
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