摘要
目的总结肝血管平滑肌脂肪瘤穿刺活检标本的组织病理学形态、免疫组化及诊断和鉴别诊断要点,探讨提高诊断准确率、降低误诊率的方法。方法对9例肝血管平滑肌脂肪瘤穿刺活检病例进行临床病理与免疫组化观察。结果 9例肝血管平滑肌脂肪瘤中女性8例,男性1例,年龄25～62岁,中位年龄43岁;肿瘤直径2～10 cm;5例为肌瘤型,3例为混合型,1例为脂肪瘤型;其中8例HMB45(+),1例HMB45(-)但melan A(+)。仅1例术前影像学诊断考虑为肝血管平滑肌脂肪瘤,而未行免疫组化检测、仅依靠光镜观察,有4例得出正确的病理诊断。结论肝血管平滑肌脂肪瘤的组织形态变化多样,穿刺活检标本更易误诊或漏诊,确切的病理诊断还需借助于免疫组化,尤其是HMB45和melan A对鉴别诊断有重要意义。
Objective To describe the clinicopathologic and immunohistochemical characteristics and differential diagnosis of nine cases of hepatic angiomyolipoma（HAML）examined by needle aspiration biopsy,in purpose to investigate the methodology and to enhance the diagnostic accuracy and lower the misdiagnosis rate.Methods Nine cases of HAML were analyzed using H E and immunohistochemical stains.Results This group of HAML was composed of 8 females and 1 male,with age ranged 25-65 years（median 43 years）.The size of the tumor was 2 cm to 10 cm.There were 5 myomatous cases,3 mixed cases and 1 lipomatous case.Immunohistochemical staining showed that 8 cases were positive for HMB-45,one was negative for HMB45 but positive for Melan A.Only one case was diagnosed with HAML by preoperative image studies.Without immunohistochemical study,correct diagnosis was achieved in only 4 cases by microscopic examination.Conclusions Angiomyolipoma exhibits a wide spectrum of morphological patterns,and it may be easily misdiagnosed or neglected.Immunohistochemical confirmation is of utmost importance to establish a definite diagnosis,in which HMB45 and Melan A are of great valuable in the differential diagnosis of HAML.
出处
《诊断病理学杂志》
CSCD
2011年第1期52-55,共4页
Chinese Journal of Diagnostic Pathology
关键词
肝肿瘤
血管平滑肌脂肪瘤
穿刺活检
免疫组化
Liver neoplasms
Angiomyolipoma
Needle aspiration biopsy
Immunohistochemistry
