中华病理学杂志
中華病理學雜誌
중화병이학잡지
Chinese Journal of Pathology
2015年
7期
495-498
,共4页
杨文萍%徐红艳%曾松涛%傅荣华%曾华%谭梅军%吴艳%熊枫%黄慧%钟梅慧%张守华%周俊霖
楊文萍%徐紅豔%曾鬆濤%傅榮華%曾華%譚梅軍%吳豔%熊楓%黃慧%鐘梅慧%張守華%週俊霖
양문평%서홍염%증송도%부영화%증화%담매군%오염%웅풍%황혜%종매혜%장수화%주준림
血管瘤%儿童%诊断,鉴别
血管瘤%兒童%診斷,鑒彆
혈관류%인동%진단,감별
Hemangima%Child%Diagnosis,differential
目的探讨不消退型先天性血管瘤（ NICH）患儿临床病理特征及鉴别诊断。方法对22例NICH临床资料、组织形态和免疫组织化学进行分析。结果22例NICH患儿男14例，女8例，就诊平均年龄4.2岁。发病部位：头面部5例、颈部3例、躯体6例、上肢5例、下肢3例。组织学呈不规则的结节状或小叶状结构，血管内皮细胞核突出血管腔内，呈现“钉突样”，结节中央通常可见1条或多条管壁厚薄不一的引流血管；小叶间为纤维组织间隔和纤维脂肪间隔，纤维组织中通常可见异常的动脉和静脉结构，小叶边缘可见淋巴管样的结构；3例可见血栓。免疫组织化学均表达CD34（22／22）、CD31（22／22）、平滑肌肌动蛋白（22／22）、波形蛋白（22／22），D2-40表达位于结节边缘，所有病例不表达Glut1。结论 NICH属于良性病变，预后较好，病理诊断需结合临床表现和组织形态特点，免疫组织化学有助于诊断和鉴别诊断。
目的探討不消退型先天性血管瘤（ NICH）患兒臨床病理特徵及鑒彆診斷。方法對22例NICH臨床資料、組織形態和免疫組織化學進行分析。結果22例NICH患兒男14例，女8例，就診平均年齡4.2歲。髮病部位：頭麵部5例、頸部3例、軀體6例、上肢5例、下肢3例。組織學呈不規則的結節狀或小葉狀結構，血管內皮細胞覈突齣血管腔內，呈現“釘突樣”，結節中央通常可見1條或多條管壁厚薄不一的引流血管；小葉間為纖維組織間隔和纖維脂肪間隔，纖維組織中通常可見異常的動脈和靜脈結構，小葉邊緣可見淋巴管樣的結構；3例可見血栓。免疫組織化學均錶達CD34（22／22）、CD31（22／22）、平滑肌肌動蛋白（22／22）、波形蛋白（22／22），D2-40錶達位于結節邊緣，所有病例不錶達Glut1。結論 NICH屬于良性病變，預後較好，病理診斷需結閤臨床錶現和組織形態特點，免疫組織化學有助于診斷和鑒彆診斷。
목적탐토불소퇴형선천성혈관류（ NICH）환인림상병리특정급감별진단。방법대22례NICH림상자료、조직형태화면역조직화학진행분석。결과22례NICH환인남14례，녀8례，취진평균년령4.2세。발병부위：두면부5례、경부3례、구체6례、상지5례、하지3례。조직학정불규칙적결절상혹소협상결구，혈관내피세포핵돌출혈관강내，정현“정돌양”，결절중앙통상가견1조혹다조관벽후박불일적인류혈관；소협간위섬유조직간격화섬유지방간격，섬유조직중통상가견이상적동맥화정맥결구，소협변연가견림파관양적결구；3례가견혈전。면역조직화학균표체CD34（22／22）、CD31（22／22）、평활기기동단백（22／22）、파형단백（22／22），D2-40표체위우결절변연，소유병례불표체Glut1。결론 NICH속우량성병변，예후교호，병리진단수결합림상표현화조직형태특점，면역조직화학유조우진단화감별진단。
Objective To investigate the clinicopathologic features and differential diagnoses of non-involuting congenital hemangioma ( NICH ) in children.Methods The clinical , morphologic and immunophenotypic characteristics of 22 cases of NICH were retrospectively analyzed.Results The mean patients′age at diagnosis was 4.2 years, with a male to female ratio of 1.75∶1.The tumors were located in the head and face (5 cases), neck (3 cases), body (6 cases), upper limbs (5 cases), and lower limbs (3 cases).Histologically, the tumor was dominated by rather large lobules of small vessels that were mostly rounded, curved, small and thin-walled, and were lined by endothelial cells surrounded by one or more layers of pericytes.The center of the lobules was occupied by one or more thin or thick walled vessels , which were surrounded by fibrous and fatty tissue , which contained abnormal arterial and venous structures.At the edge of the lobules there were lymphatic vessels.Immunohsitochemical study showed that tumor cells in NICH were positive for CD34 ( 22/22 ) , CD31 ( 22/22 ) , SMA ( 22/22 ) , vimentin ( 22/22 ) and Glut1 (0/22).D2-40 expression was located at the edge of the capillary lobules.Conclusions NICH is a benign lesion.Clinically and pathologically , it needs to be differentiated from rapidly involuting congenital hemangioma ,infantile hemangiomas ,tufted angioma ,vascular malformation ,and others.
