中国医药
中國醫藥
중국의약
CHINA MEDICINE
2013年
z1期
7-8
,共2页
王晓冰%邹伟%易智君%吴惠如%李勇生
王曉冰%鄒偉%易智君%吳惠如%李勇生
왕효빙%추위%역지군%오혜여%리용생
肺肿瘤%微小瘤%免疫组化
肺腫瘤%微小瘤%免疫組化
폐종류%미소류%면역조화
Lung neoplasms%Tumourlet%Immunohistochemistry
目的 观察肺微小瘤的临床病理学、影像学特点,探讨其免疫组织化学(免疫组化)特征及鉴别诊断.方法 采用组织学、免疫组化及组织化学技术对1例肺微小瘤进行光镜观察及免疫标记,并结合相关文献对其临床表现、影像学、组织形态和免疫组化特点等进行综合分析.结果 患者男性,61岁,肿瘤组织学表现为散发多灶性镜下结节,呈簇状、巢状或索团状,分布于支气管扩张症受损的支气管壁旁及细小支气管周围,瘤细胞呈圆形或短梭形,大小较一致,核圆或卵圆形,染色深,未见核分裂及坏死.免疫组化染色示:细胞角蛋白、神经元特异性烯醇化酶、神经突触素、嗜铬粒素、5-羟色胺、胃泌激素及降血钙素均阳性,细胞嗜银性强.结论 原发于支气管周围的微小瘤较为罕见,临床影像学特征不明显,可能是肺类癌发生的早期阶段,免疫组化染色有助于该肿瘤的诊断,应与神经内分泌细胞增生、类癌、小细胞癌、微小肺脑膜瘤样结节及小副神经节瘤等鉴别.手术切除预后较好.
目的 觀察肺微小瘤的臨床病理學、影像學特點,探討其免疫組織化學(免疫組化)特徵及鑒彆診斷.方法 採用組織學、免疫組化及組織化學技術對1例肺微小瘤進行光鏡觀察及免疫標記,併結閤相關文獻對其臨床錶現、影像學、組織形態和免疫組化特點等進行綜閤分析.結果 患者男性,61歲,腫瘤組織學錶現為散髮多竈性鏡下結節,呈簇狀、巢狀或索糰狀,分佈于支氣管擴張癥受損的支氣管壁徬及細小支氣管週圍,瘤細胞呈圓形或短梭形,大小較一緻,覈圓或卵圓形,染色深,未見覈分裂及壞死.免疫組化染色示:細胞角蛋白、神經元特異性烯醇化酶、神經突觸素、嗜鉻粒素、5-羥色胺、胃泌激素及降血鈣素均暘性,細胞嗜銀性彊.結論 原髮于支氣管週圍的微小瘤較為罕見,臨床影像學特徵不明顯,可能是肺類癌髮生的早期階段,免疫組化染色有助于該腫瘤的診斷,應與神經內分泌細胞增生、類癌、小細胞癌、微小肺腦膜瘤樣結節及小副神經節瘤等鑒彆.手術切除預後較好.
목적 관찰폐미소류적림상병이학、영상학특점,탐토기면역조직화학(면역조화)특정급감별진단.방법 채용조직학、면역조화급조직화학기술대1례폐미소류진행광경관찰급면역표기,병결합상관문헌대기림상표현、영상학、조직형태화면역조화특점등진행종합분석.결과 환자남성,61세,종류조직학표현위산발다조성경하결절,정족상、소상혹색단상,분포우지기관확장증수손적지기관벽방급세소지기관주위,류세포정원형혹단사형,대소교일치,핵원혹란원형,염색심,미견핵분렬급배사.면역조화염색시:세포각단백、신경원특이성희순화매、신경돌촉소、기락립소、5-간색알、위비격소급강혈개소균양성,세포기은성강.결론 원발우지기관주위적미소류교위한견,림상영상학특정불명현,가능시폐유암발생적조기계단,면역조화염색유조우해종류적진단,응여신경내분비세포증생、유암、소세포암、미소폐뇌막류양결절급소부신경절류등감별.수술절제예후교호.
Objective To investigate clinicopathological characteristics and differential diagnosis of pulmonary tumourlet.Methods One case of pulmonary tumourlet was studied by light microscopy,histochemistry,and immunohistochemistry,and reviewed relevant literatures to analyze the clinical,morphological,immunohistochemical features,treatment and prognosis of the pulmonary tumourlet.Results The patient was a 61 years old man.The pulmonary tumourlet was characterized histologically by multi-focal nodules and most were displayed only under microscopy.The tumourlet cells were arranged in clusters and foci of fascicles which were situated in the surrounding bronchial wall and bronchioles adjacent to bronchiectatic lesion,or in the scar tissues.The tiny tumours were consisted of a relatively uniform population small ovoid cells.Their nuclei were circular,oval or spindle.Mitotic activity and necrosis were absent.Intensive positive immunostaining for cytokeratin,neuron speicfic enolase,synaptophysin,chromogranin A,5-hydroxytryptamine,gastrin and calcitonin were detected.The cells were strongly argyrophilic on Grimelius staining.Conclusions The pulmonary tumourlet is a very rare tumour with no specific imaging features and examination,so it may be the early stage of typical carcinoid.The diagnosis is based on immunohistochemical staining.It should be differentiated from other lesions of the bronchial,including diffuse idiopathic pulmonary neuroendoefine cell hyperplasia,carcinoid carcinoma,small cell carcinoma,minute pulmonary meningioma-like nodule and paraganglioma.For the treatment of the pulmonary tumourlet,surgical resection has a good prognosis.
