摘要
目的探讨孤立性支气管乳头状瘤(solitary bronchial papilloma,SBP)的临床病理特点、诊断要点及与人乳头状瘤病毒(human papilloma virus,HPV)的感染情况。方法对4例SBP标本进行组织病理学观察和HPV总、HPV16及HPV6/11的检测,并复习临床资料及相关文献。结果1例老年女性患者肿瘤位于主支气管,为鳞状细胞乳头状瘤,灶性癌变,伴微浸润。3例为混合性鳞状细胞和腺性乳头状瘤,2例伴中度不典型增生,发病年龄25～73岁(平均54岁)。肿瘤位于主支气管及段支气管,纤维血管轴心周围被覆复层非角化鳞状上皮及柱状上皮。4例均呈外生性生长,1例伴内翻性生长。HPV检测均为阴性。结论SBP是发生在成人的一种罕见肺肿瘤,个别病例在鳞状上皮出现异型性的基础上可以发生癌变。建议外科手术完整切除病变,全面观察,以防误诊和漏诊。
Purpose To explore the clinicopathological features,differential diagnosis of solitary bronchial papilloma,and its relation with and human papilloma virus infection.Methods Four cases of SBP were studied by routine histologic,immunohistochemical staining and in situ hybridization,together with review of the literature.Results One of four lesions was squamous cell papilloma,with focal malignant change of squamous cell carcinoma with microinvasion.The case was an old woman and the cancer located in central bronchus.Others were mixed squamous cell and glandular papilloma,and two cases with features of moderate cytologic atypia.The age ranged from 25 to 73 years （average 54）,and tumors were located in the bronchi and segmental bronchi.Papillary arborizing connective tissue stalks were lined by both squamous and glandular epithelium.Four papillomas were exophytic,with one case inverted partly.Four cases were examined for HPV DNA and all were negative.Conclusions SBP in adults is a rare lung neoplasm.Based on uncommon cases association with malignant change,all endobronchial papillomas should be completely excised.
出处
《临床与实验病理学杂志》
CAS
CSCD
北大核心
2010年第1期67-72,共6页
Chinese Journal of Clinical and Experimental Pathology
