CAJ | 학술논문

目的探讨小叶毛细血管瘤(LCH)的临床、病理表现及病理特点,以提高认识.方法对69例LCH患者的标本行常规病理切片检查及免疫组织化学检查.结果 69例LCH患者年龄4～ 80岁,平均42岁,男34例,女35例,病变发生在头颈部50例,其他部位19例,其中病变位于左主支气管合并颅内1例.肿瘤大小平均约1 cm,部分呈息肉状.肿瘤大部分位于皮肤或黏膜内.其中1例发生在左主支气管呈菜花状同时合并颅内病变.肿瘤由小叶状分布的薄壁和厚壁血管大量增生,形成肉芽组织样病变;血管间质水肿,有较多炎性细胞浸润;血管内皮细胞CD34(+),血管周梭形细胞平滑肌肌动蛋白(+).结论 LCH年龄、性别、发病部位有明显的特点,极少数复发.发病机制目前不明确.极少见于发生在气管,发生于中枢神经系统则更加少见.应该早期警惕是否有重要脏器病变的合并发生,采取早期手术完整肿物切除和/或辅助放疗,以免延误病情,产生严重后果.
목적 탐토소협모세혈관류(LCH)적림상、병리표현급병리특점,이제고인식.방법 대69례LCH환자적표본행상규병리절편검사급면역조직화학검사.결과 69례LCH환자년령4～ 80세,평균42세,남34례,녀35례,병변발생재두경부50례,기타부위19례,기중병변위우좌주지기관합병로내1례.종류대소평균약1 cm,부분정식육상.종류대부분위우피부혹점막내.기중1례발생재좌주지기관정채화상동시합병로내병변.종류유소협상분포적박벽화후벽혈관대량증생,형성육아조직양병변;혈관간질수종,유교다염성세포침윤;혈관내피세포CD34(+),혈관주사형세포평활기기동단백(+).결론 LCH년령、성별、발병부위유명현적특점,겁소수복발.발병궤제목전불명학.겁소견우발생재기관,발생우중추신경계통칙경가소견.응해조기경척시부유중요장기병변적합병발생,채취조기수술완정종물절제화/혹보조방료,이면연오병정,산생엄중후과.
Objective To explore the chnical manifestation,pathological features and characteristics of lobular capillary hemangioma (LCH),so as to raise awareness.Methods Sixty-nine cases of LCH were studied by routine histopathologic and immunohistochemical examinations.Results The age range of the 69 patients including 34 males and 35 females with LCH was 4-80 years,with an average age of 42 years.The lesions of 50 cases were located in head and neck region,and the other 19 cases were in other parts of the body,with 1 case in the left main bronchus and intracalvarium.The average diameter of the tumors was about 1 cm,and parts of the tumors showed polypoid masses.Most of the tumors were in the skin and mucosa.Granulomatous lesions showed the proliferation of thin-walled and thick-walled capillaries in a lobular pattern.The vascular interstitium was edematous and was infiltrated by the inflammatory cells.Immunohistochemical examination showed CD34 positive in the endothelial cells and smooth muscle actin positive in the peri-vascular spindle cells.Conclusions Studies of LCH show the obvious features on age,gender and diseased location,and very few have a relapse.Its pathogenesis is still unclear.LCH is rarely found in the trachea,and is more rarely in the central nervous system.So far,there is no case report to show LCH occurs both in the bronchus and intracalvarium.In the special case,the early lesion is found in the left main bronchus.Although the patient is treated,LCH still recurs for many times in a short period.Finally the tumor is also found in the intracalvarium.Therefore,it's critical to alert whether LCH also occurs in the important organs at the early stage.Complete surgical resection and / or adjuvant radiotherapy can avoid delaying the treatment and the subsequent serious outcomes.