摘要
目的探讨上皮样血管瘤的临床病理学特征、免疫学表型及鉴别诊断。方法分析和观察5例上皮样血管瘤的临床资料和组织学形态,应用免疫组化EnVision法研究其免疫表型,所用抗体包括CD43、CD3、CD45RO、CD20、CD79α、Ki-67、CD31、CD34、第Ⅷ因子相关抗原(FⅧRAg)、CD68和CK。结果上皮样血管瘤多见于女性,好发于头颈部,多表现为皮肤单发的小结节或丘疹样病变。病变位于真皮内或皮下,以成簇增生的血管为主;其中3例为毛细血管型,2例为小至中等大的血管型。血管内衬胞质丰富、嗜伊红深染的上皮样内皮细胞。除内衬管腔外,内皮细胞还可在血管腔内生长或在血管周围呈实性片状增生或排列成条索状;部分细胞的胞质内含有空泡,拟形成原始血管腔。2例的间质内可见多少不等的慢性炎症细胞反应,但不见淋巴滤泡形成。免疫组化显示,上皮样血管瘤中的内皮细胞CD31和FⅧRAg等内皮标记强(+)。结论上皮样血管瘤是一种良性的血管瘤,诊断主要靠特征性组织学特点,但应注意与木村病鉴别。
Objective To investigate the chnicopathologic features, immunophenotypes and differential diagnosis of epithehoid hemangioma （EH）. Methods Five cases of EH were evaluated by light microscopy and immunohistochemistry. Results In this series, EH had a female predilection and arose most frequently in the head and neck region, and appeared only as a small skin nodule or red plaque. Histologically, EH involved the dermis or subcutis. All the 5 EH cases showed prominent proliferation of vessels of capillary-sized in 3 cases and small to medium-sized in 2 case. The vessels were lined by epithelioid endothelial cells with abundant eosinophilic cytoplasm, and the endothelial cells also proliferated within the lumen and grew in sheets or cords adjacent to the vessel walls. Some endothelial cells contained intracytoplasmic vacuoles, suggesting formation of primitive vessels. Associated inflammatory component was noted in 2 cases. Lymphoid follicles however were not present. Immunohistochemical study In EH revealed that the epithelioid endothelial cells showed strong reactivity to CD31 and factor Ⅷ-related antigen. Conclusion EH represents a benign vascular tumor. The diagnosis of EH depends on its especial pathologic character istics, and it is must be differenteiated with Kimura＇s disease.
出处
《诊断病理学杂志》
CSCD
2008年第1期51-53,共3页
Chinese Journal of Diagnostic Pathology
