临床和实验医学杂志
臨床和實驗醫學雜誌
림상화실험의학잡지
JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE
2015年
9期
770-773
,共4页
赵丹%张丽丽%张淑红%周立娟%苏丹%张晨%张海青
趙丹%張麗麗%張淑紅%週立娟%囌丹%張晨%張海青
조단%장려려%장숙홍%주립연%소단%장신%장해청
肺%透明细胞%免疫组化
肺%透明細胞%免疫組化
폐%투명세포%면역조화
Lung%Clear cell%Immunohistochemistry
目的:探讨具有透明细胞形态的肺肿瘤的临床病理特征及鉴别诊断方法。方法选择60例具有透明细胞形态的肺肿瘤,对其临床资料、病理形态特点及免疫组化表达情况进行分析。结果27例具有透明细胞形态的肺腺癌 CK7、TTF -1、Napsin A 阳性,15例肺透明细胞性鳞状细胞癌 CK5/6、p63、p40阳性,两者免疫组化表达的差异具有显著性( P <0.001)。6例肺透明细胞癌(肺大细胞癌亚型)肿瘤组织分化差,异型性明显,核分裂像多见,且不具有明确的肺腺癌及肺鳞状细胞癌分化特征。9例转移性透明细胞性肾细胞癌与3例肺透明细胞瘤(肺“糖瘤”)病理形态相似,均为大量透明细胞及丰富的薄壁血管,但前者巢状结构比较清晰,间质内含较多纤细的薄壁血管,常见淋巴细胞浸润,免疫组化 Vim、CK - L 阳性,而肺透明细胞瘤的薄壁血管穿插在肿瘤细胞间,有时可形成鹿角样结构,免疫组化 HMB45、S -100阳性,PAS 染色阳性。结论具有透明细胞形态的肺肿瘤的病理诊断及鉴别诊断需结合病理形态、免疫组化及特殊染色综合判断。
目的:探討具有透明細胞形態的肺腫瘤的臨床病理特徵及鑒彆診斷方法。方法選擇60例具有透明細胞形態的肺腫瘤,對其臨床資料、病理形態特點及免疫組化錶達情況進行分析。結果27例具有透明細胞形態的肺腺癌 CK7、TTF -1、Napsin A 暘性,15例肺透明細胞性鱗狀細胞癌 CK5/6、p63、p40暘性,兩者免疫組化錶達的差異具有顯著性( P <0.001)。6例肺透明細胞癌(肺大細胞癌亞型)腫瘤組織分化差,異型性明顯,覈分裂像多見,且不具有明確的肺腺癌及肺鱗狀細胞癌分化特徵。9例轉移性透明細胞性腎細胞癌與3例肺透明細胞瘤(肺“糖瘤”)病理形態相似,均為大量透明細胞及豐富的薄壁血管,但前者巢狀結構比較清晰,間質內含較多纖細的薄壁血管,常見淋巴細胞浸潤,免疫組化 Vim、CK - L 暘性,而肺透明細胞瘤的薄壁血管穿插在腫瘤細胞間,有時可形成鹿角樣結構,免疫組化 HMB45、S -100暘性,PAS 染色暘性。結論具有透明細胞形態的肺腫瘤的病理診斷及鑒彆診斷需結閤病理形態、免疫組化及特殊染色綜閤判斷。
목적:탐토구유투명세포형태적폐종류적림상병리특정급감별진단방법。방법선택60례구유투명세포형태적폐종류,대기림상자료、병리형태특점급면역조화표체정황진행분석。결과27례구유투명세포형태적폐선암 CK7、TTF -1、Napsin A 양성,15례폐투명세포성린상세포암 CK5/6、p63、p40양성,량자면역조화표체적차이구유현저성( P <0.001)。6례폐투명세포암(폐대세포암아형)종류조직분화차,이형성명현,핵분렬상다견,차불구유명학적폐선암급폐린상세포암분화특정。9례전이성투명세포성신세포암여3례폐투명세포류(폐“당류”)병리형태상사,균위대량투명세포급봉부적박벽혈관,단전자소상결구비교청석,간질내함교다섬세적박벽혈관,상견림파세포침윤,면역조화 Vim、CK - L 양성,이폐투명세포류적박벽혈관천삽재종류세포간,유시가형성록각양결구,면역조화 HMB45、S -100양성,PAS 염색양성。결론구유투명세포형태적폐종류적병리진단급감별진단수결합병리형태、면역조화급특수염색종합판단。
Objective To explore the clinicopathological characteristics and differential diagnosis of lung tumors with clear cell morpholo-gy. Methods The data of clinicopathological features and immunohistochemistry of 60 lung tumors with clear cell morphology were reviewed. Re-sults Twenty - seven cases of lung adenocarcinoma with clear cell morphology:immunohistochemical staining:positive for CK7,TTF - 1,Napsin A,compared to 15 cases of clear cell lung squamous cell:positive for CK5 / 6,p40,p63,showed a significant difference( P < 0. 001). 6 cases of lung clear cell cancer(a subtype of large cell lung cancer):it poorly differentiated,atypia was remarkable and mitoic was common,and had no clear differentiation features of lung adenocarcinoma and squamous cell carcinoma. 9 cases of metastatic clear cell renal cell carcinoma were similar to 3 cases of lung clear cell tumor("sugar" tumor)with clear cell and thin - walled vessels. The former was arranged in a prominent nesting pat-tern separated by thin - walled vessels,lymphocytes were easy to see,and positive for Vim,CK - L. The latter:thin - walled blood vessels inter-spersed between tumor cells,antler - like structure can be formed sometimes and positive for HMB45,S - 100 and PAS. Conclusion The diag-nosis of lung tumors with clear cell morphology depends on comprehensive analysis of clinical data,histopathology and immunohistochemistry.