中华病理学杂志
中華病理學雜誌
중화병이학잡지
Chinese Journal of Pathology
2013年
6期
376-380
,共5页
肝肿瘤%血管肉瘤%诊断
肝腫瘤%血管肉瘤%診斷
간종류%혈관육류%진단
Liver neoplasms%Hemangiosarcoma%Diagnosis
目的 探讨肝原发性血管肉瘤的临床病理特点并复习相关文献.方法 搜集并分析解放军总医院病理科1988至2012年诊断的20例肝原发性血管肉瘤患者的临床表现、肿瘤病理形态特征及免疫表型特点(CD34、CD31、第八因子相关抗原、CK、GPC-3、Hepatocyte、波形蛋白、PTEN、结蛋白、CD117、Ki-67)等并进行随访.结果 20例患者中,男性11例,女性9例,平均年龄53.2岁(7～86岁),肿瘤发生部位:肝右叶11例,肝左叶6例,左右叶弥漫生长3例.大体观察:肿瘤组织呈暗红色,蜂窝状,伴出血坏死.镜下观察:形态多样,有海绵状血管瘤样、上皮样血管内皮细胞瘤样改变,移植肝复发肿瘤与肝原发肿瘤形态有差别,但均能找到较特异的血管肉瘤诊断特征.免疫组织化学染色显示肿瘤组织至少表达CD31、CD34、第八因子相关抗原中的1项,波形蛋白表达均为弥漫阳性(20/20),10例PTEN低表达(10/20),Ki-67阳性指数均大于10％,最高达60％.1例CK表达阳性(1/20),结蛋白、CD117、Hepatocyte及GPC-3均为阴性.结论 原发性肝血管肉瘤是一种罕见的预后很差的恶性肿瘤,结合组织学形态并联合应用多项血管内皮标志物可作出明确诊断.
目的 探討肝原髮性血管肉瘤的臨床病理特點併複習相關文獻.方法 搜集併分析解放軍總醫院病理科1988至2012年診斷的20例肝原髮性血管肉瘤患者的臨床錶現、腫瘤病理形態特徵及免疫錶型特點(CD34、CD31、第八因子相關抗原、CK、GPC-3、Hepatocyte、波形蛋白、PTEN、結蛋白、CD117、Ki-67)等併進行隨訪.結果 20例患者中,男性11例,女性9例,平均年齡53.2歲(7～86歲),腫瘤髮生部位:肝右葉11例,肝左葉6例,左右葉瀰漫生長3例.大體觀察:腫瘤組織呈暗紅色,蜂窩狀,伴齣血壞死.鏡下觀察:形態多樣,有海綿狀血管瘤樣、上皮樣血管內皮細胞瘤樣改變,移植肝複髮腫瘤與肝原髮腫瘤形態有差彆,但均能找到較特異的血管肉瘤診斷特徵.免疫組織化學染色顯示腫瘤組織至少錶達CD31、CD34、第八因子相關抗原中的1項,波形蛋白錶達均為瀰漫暘性(20/20),10例PTEN低錶達(10/20),Ki-67暘性指數均大于10％,最高達60％.1例CK錶達暘性(1/20),結蛋白、CD117、Hepatocyte及GPC-3均為陰性.結論 原髮性肝血管肉瘤是一種罕見的預後很差的噁性腫瘤,結閤組織學形態併聯閤應用多項血管內皮標誌物可作齣明確診斷.
목적 탐토간원발성혈관육류적림상병리특점병복습상관문헌.방법 수집병분석해방군총의원병이과1988지2012년진단적20례간원발성혈관육류환자적림상표현、종류병리형태특정급면역표형특점(CD34、CD31、제팔인자상관항원、CK、GPC-3、Hepatocyte、파형단백、PTEN、결단백、CD117、Ki-67)등병진행수방.결과 20례환자중,남성11례,녀성9례,평균년령53.2세(7～86세),종류발생부위:간우협11례,간좌협6례,좌우협미만생장3례.대체관찰:종류조직정암홍색,봉와상,반출혈배사.경하관찰:형태다양,유해면상혈관류양、상피양혈관내피세포류양개변,이식간복발종류여간원발종류형태유차별,단균능조도교특이적혈관육류진단특정.면역조직화학염색현시종류조직지소표체CD31、CD34、제팔인자상관항원중적1항,파형단백표체균위미만양성(20/20),10례PTEN저표체(10/20),Ki-67양성지수균대우10％,최고체60％.1례CK표체양성(1/20),결단백、CD117、Hepatocyte급GPC-3균위음성.결론 원발성간혈관육류시일충한견적예후흔차적악성종류,결합조직학형태병연합응용다항혈관내피표지물가작출명학진단.
Objective To investigate the clinicopathological characteristics,differential diagnosis,and prognosis of primary hepatic angiosarcoma,and to review the literature.Methods Twenty cases of primary hepatic angiosarcoma were analyzed by gross examination and light microscopy.Immunostaining was performed to detect the expression of CD34,CD31,F Ⅷ RAg,CK,GPC-3,Hepatocyte,vimentin,PTEN,desmin,and CD117.Results The age of the patients ranged from 7 to 86 years.Eleven cases were male,and 9 were female.All cases showed no specific clinical manifestations and imaging results.Macroscopically,the tumors showed diffuse multi-nodular or single nodular patterns with hemorrhage.Microscopically,there were various patterns such as cavernous vascular space and epithelioid hemangioendothelioma-like appearances; however,specific pathological diagnostic features of angiosarcoma still existed in all cases.All of the cases expressed at least one of the three immunohistochemical markers:CD31,CD34 and/or FⅧRag.Ten cases had PTEN low expression.Ki-67 proliferative index was more than 10％ in all cases.None of cases expressed desmin,CD117,GPC-3 or Hepatocyte.Conclusions Primary hepatic angiosarcoma is a rare malignant tumor.Detailed morphological observation and using various vascular endothelial immunohistochemical markers can help to establish the diagnosis accurately.
