【摘要】：肺腺纖維瘤(pulmonary adenofibroma)是一種非常罕見的肺原發(fā)性上皮與間質(zhì)雙相分化的良性腫瘤,多為胸膜下的實(shí)性界清結(jié)節(jié),上皮呈簡單的腺樣結(jié)構(gòu),偶有乳頭或葉狀結(jié)構(gòu),上皮周圍圍繞著豐富的間質(zhì),間質(zhì)由溫和的梭形細(xì)胞及膠原組成。在目前有限的病例報(bào)道中,尚未發(fā)現(xiàn)與腫瘤相關(guān)的復(fù)發(fā)與轉(zhuǎn)移。由于既往報(bào)道極少,對(duì)此類疾病的認(rèn)識(shí)不足,在冰凍組織病理診斷或穿刺組織病理診斷中,容易將其誤診為惡性病變。本文報(bào)道1例肺腺纖維瘤,患者為74歲女性,體檢時(shí)發(fā)現(xiàn)左肺外周型腫物,近年緩慢增大,遂于胸腔鏡下行肺葉楔形切除手術(shù)。肉眼觀腫物呈類圓形,邊界清晰,但無明顯包膜,切面灰白質(zhì)韌。顯微鏡下腫瘤由結(jié)構(gòu)簡單的腺樣分化的上皮及形態(tài)溫和的梭形細(xì)胞間質(zhì)兩種成分組成,每個(gè)間質(zhì)細(xì)胞周圍圍繞著粗細(xì)不一的膠原束,偶見小的粗乳頭狀或葉狀結(jié)構(gòu)。免疫組織化學(xué)染色顯示腺上皮與肺泡上皮表型一致,間質(zhì)細(xì)胞CD34、B淋巴細(xì)胞瘤-2(B-cell lymphoma-2,Bcl-2)、CD99和雌激素受體(estrogen receptor,ER)陽性,S-100、平滑肌肌動(dòng)蛋白(smooth muscle actin,SMA)以及間皮標(biāo)記等均為陰性。短期隨訪患者無復(fù)發(fā)或轉(zhuǎn)移表現(xiàn)。本文回顧了國內(nèi)外已報(bào)道的相關(guān)病例,并對(duì)肺腺纖維瘤可能的組織學(xué)起源進(jìn)行初步探討。
[Abstract]:Pulmonary adenofibroma (pulmonary adenofibroma) is a very rare benign tumor with biphasic differentiation between primary epithelial and stroma of the lung. Most of them are solid borderline nodules under pleura. The epithelial cells have simple adenoid structure and occasionally papilla or leaflike structure. The stroma is surrounded by abundant stroma, and the stroma is composed of mild fusiform cells and collagen. In the current limited case reports, no tumor-related recurrence and metastasis has been found. Because there are few reports in the past and there is not enough understanding of this kind of disease, it is easy to misdiagnose it as malignant lesion in the pathological diagnosis of frozen tissue or puncture tissue. This paper reports a case of pulmonary adenofibroma, a 74-year-old female. The peripheral mass of the left lung was found during physical examination, which increased slowly in recent years and was resected by thoracoscopy. The masses were round, with clear boundary, but no obvious envelope, and the section was gray and white matter tough. Under microscope, the tumor is composed of simple adenoid differentiated epithelial cells and mild fusiform cell stroma. Each stroma cell is surrounded by collagen bundles of different thickness, and occasionally has a small thick papilla or leaflike structure. Immunohistochemical staining showed that the phenotype of adenoepithelial cells was the same as that of alveolar epithelial cells, but the positive rates of CD34,B lymphocytoma-2 (B-cell lymphoma-2,Bcl-2), CD99 and estrogen receptor (estrogen receptor,ER), S 鈮，

本文編號(hào)：2516224