摘要
目的探讨高分化乳头状间皮肿瘤(WDPMT)的临床病理学特征、免疫表型、诊断及鉴别诊断。方法回顾性分析6例WDPMT的临床及组织病理学特征,采用免疫组化EnVision两步法检测CK、Calretinin、CK5/6、WT-1、HBME1、D2-40、Vimentin、ER、PR、PAX-8、TTF-1、NapsinA及Ki-67表达,并复习相关文献。结果6例WDPMT患者中男性2例,女性4例,年龄45~73岁(平均年龄58岁),3例位于腹膜、2例位于胸膜、1例位于膈肌,肿物单发或散在粟粒状或聚集小结节,镜下见肿瘤由乳头状结构组成,乳头间质为纤维血管轴心,表面衬覆温和、单层扁平或立方的上皮样细胞,无明显异型性。免疫表型:Calretinin、HBME1等间皮标记阳性,PAX-8阳性1例(1/6),Vimentin阳性1例(1/6),ER、PR、TTF-1、NapsinA阴性,Ki-67增殖指数<10%。结论WDPMT是一种罕见的良性或交界性的间皮肿瘤,完整切除可长期生存,需要与形态相似的恶性间皮瘤、转移性腺癌、浆液性肿瘤等鉴别,以提高对本病的认识并防止过度治疗。
Objective To investigate the clinicopathological characteristics,immunophenotype,diagnosis and differential diagnosis of well-differentiated papillary mesothelial tumor(WDPMT).Methods The clinical and histopathological features of 6 cases of WDPMT were analyzed retrospectively.The expression of CK,Calretinin,CK5/6,WT-1,HBME1,D2-40,Vimentin,ER,PR,PAX-8,TTF-1,NapsinA and Ki-67 was detected by immunohistochemical EnVision two-step method,and the related literature was reviewed.Results Among the 6 patients with WDPMT,2 were male,4 were female,aged 45-73 years(average age 58 years),3 were located in the peritoneum,2 were located in the pleura,and 1 was located in the diaphragm.The tumors were solitary or scattered in miliary or aggregated nodules.Microscopically,the tumors were composed of papillary structures.The papillary stroma was the axis of fiber vessels,and the surface was lined with mild,single-layer flat or cubic epithelioid cells,without obvious atypia.Immunophenotypically,Calretinin,HBME1 and other mesothelial markers were positive,PAX-8 was positive in 1 case(1/6),Vimentin was positive in 1 case(1/6),ER,PR,TTF-1 and NapsinA were negative,and Ki-67 proliferation index<10%.Conclusion Well-differentiated papillary mesothelial tumor is a rare benign or borderline mesothelial tumor,which can survive for a long time after complete resection.It needs to be differentiated from malignant mesothelioma,metastatic adenocarcinoma and serous tumor with similar morphology,so as to improve the understanding of the disease and prevent over treatment.
作者
张莹
戴文斌
李文华
梁越
ZHANG Ying;DAI Wen-bin;LI Wen-hua;LIANG Yue(Department of Pathology,Liuzhou People’s Hospital,Liuzhou 545006,China;Department of Pathology,Liuzhou Workers’Hospital,Liuzhou 545005,China)
出处
《诊断病理学杂志》
2023年第10期956-959,共4页
Chinese Journal of Diagnostic Pathology
关键词
高分化乳头状间皮肿瘤
鉴别诊断
免疫组化
Well-differentiated papillary mesothelial tumor
Differential diagnosis
Immunohistochemistry
