【摘要】：目的 探討淋巴結(jié)淋巴管肌瘤病(lymphangiomyomatosis,LAM)的臨床病理學(xué)特征。方法 復(fù)習(xí)1例子宮內(nèi)膜樣腺癌合并盆腔淋巴結(jié)LAM的臨床資料及病理特征,對(duì)其行HE及免疫組化En Vision法染色并復(fù)習(xí)相關(guān)文獻(xiàn)。結(jié)果 子宮內(nèi)膜呈高-中分化子宮內(nèi)膜樣腺癌改變,盆腔淋巴結(jié)被膜及髓質(zhì)內(nèi)見(jiàn)增生的LAM細(xì)胞呈梭形、上皮樣或多角形,圍繞腔隙排列,細(xì)胞質(zhì)嗜酸性或空泡樣,細(xì)胞無(wú)明顯異型性,未見(jiàn)核分裂象。免疫表型:SMA、Caldesmon、desmin、vimentin、ER和PR均陽(yáng)性,腔隙內(nèi)襯細(xì)胞CD34和D2-40均陽(yáng)性,上皮樣瘤細(xì)胞HMB-45陽(yáng)性,Melan-A陰性,Ki-67增殖指數(shù)1%。結(jié)論 LAM臨床較為少見(jiàn),好發(fā)于肺部,子宮內(nèi)膜樣腺癌合并盆腔淋巴結(jié)LAM極為罕見(jiàn),結(jié)合組織學(xué)形態(tài)、臨床特點(diǎn)及免疫組化染色可確診,為今后進(jìn)一步分析LAM的機(jī)制及治療提供重要價(jià)值。
[Abstract]:Objective to investigate the clinicopathological features of lymphangiomyomyosis laminae (Lam) in lymph nodes. Methods the clinical and pathological features of a case of endometrioid adenocarcinoma with pelvic lymph node LAM were reviewed, and the relevant literatures were reviewed by HE and immunohistochemical staining with en Vision method. Results the endometrium showed a well-differentiated endometrial adenocarcinoma. The proliferative LAM cells were spindle-shaped, epithelioid or polygonal, arranged around the lacunae, cytoplasm eosinophilic or vacuolar, in pelvic lymph node capsule and medulla. There was no obvious heterogeneity and no mitotic appearance in the cells. The immunophenotype was positive for ER and PR, positive for CD34 and D2-40 in lacunar lining cells, and positive for HMB-45 positive for epithelioid tumor cells. The Ki-67 proliferative index was 1% in epithelioid tumor cells. Conclusion LAM is rare in clinic, it is prone to occur in lung, and LAM in pelvic lymph nodes is extremely rare in endometrioid adenocarcinoma. Combined with histological morphology, clinical features and immunohistochemical staining, it can be diagnosed. It provides important value for further analysis of the mechanism and treatment of LAM.
【作者單位】： 山東省聊城市第二人民醫(yī)院病理科;山東省聊城市第二人民醫(yī)院婦科;
【分類(lèi)號(hào)】：R737.33

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