摘要
目的 观察肝、肾血管平滑肌脂肪瘤 (AML)的临床病理特点、免疫组化染色 ,比较其异同点。方法 采用常规处理、HE染色及免疫组化SP方法对 12例肝AML和 38例肾AML的形态和免疫表型进行比较 ,对肝和肾AML的 3种肌样细胞和脂肪所占肿瘤比例作了Wilcoxon秩和检验。结果 12例肝AML中男女比率为 2∶10 ,平均年龄 4 1岁 ;38例肾AML男女比率 14∶2 4 ,平均 4 3岁。肿瘤均由畸形的血管、脂肪和肌样细胞构成。肌样细胞又分为上皮样、中间型和梭形 3种。在 12例肝AML中有 6例上皮样细胞所占比例大于 5 0 % ,而在 38例肾AML中均小于 2 5 %。细胞核异型性前者也较后者多见且严重 ,梭形细胞则少于后者 ;在前者上皮样细胞以围绕薄壁血管为主 ,偶见厚壁血管 ,而后者正相反 ;另外前者常见髓外造血 ,而肾AML无此现象。免疫组化染色肝AML常见HMB4 5强阳性 ,SMA局灶阳性 ,而肾AML中SMA强阳性 ,HMB4 5散在阳性。结论 AML的组织学形态多样 ,发生于肝肾的AML彼此形态亦有明显差别 ,3种成分的比例和分布各异。免疫组化HMB4 5、SMA表达的强弱也不相同。
Objective To investigate the clinicopathological and immunohistochemical characteristics of hepatic angiomyolipoma (AML) and renal AML, and to compare the similarities and differences between the two. Methods Hematoxylin-eosin staining and SP immunohistochemical staining were performed on the specimens resected during operation of 12 cases of hepatic AML, 2 males and 10 females, aged 41, and 38 renal AML cases, 14 males and 24 females, aged 43. Wilcoxon rank test was made on the proportions of the 3 kinds of myoid cells and fat tissues. Results All tumors were composed of three basic components: blood vessels, fatty tissue, and myoid cells epithelioid, spindle, or intermediate in shape. Epithelioid cells accounted for more than 50% of the cells in 6 out of the 12 hepatic AML cases often with apparent cellular and nuclear atypia (12/12), and accounted for less than 25% in all renal AML cases. Spindle-shaped cells were scarcely observed in hepatic AML and were common in renal AML. Nuclear atypia was observed in 20 out of the 38 renal AML cases, 18 cases being mild and 1 being moderate. Fat cells accounted for less than 50% in hepatic AML, and more than 50% in renal AML ( P =0.001). Extramedullary hematopoietic tissue was often seen in hepatic AML but never observed in renal AML. Strong positivity of HMB45 and focal positivity of SMA were common in hepatic AML and strong positivity of SMA and sporadic positivity of HMB45 were observed in the renal AML specimens. Conclusion The histological composition of AML is highly variable in the proportion and distribution of the 3 component cells between hepatic AML and renal AML.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2003年第13期1142-1145,共4页
National Medical Journal of China
