摘要
目的探讨肺微小脑膜上皮样结节(MPMN)临床病理学特征。方法收集2019年4月至2022年9月47例病理诊断为MPMN的病例进行年龄、性别、部位、临床表现、影像学(CT)、伴随疾病、单病灶和多病灶、肿瘤大小等情况进行对比统计分析。临床病理特征方面通过组织学、免疫组化,同时与肺脑膜瘤的鉴别方面进行对比分析。结果47例患者年龄范围36~80岁,平均59.7岁。发生部位:左上9例、左下14例、右上8例、右下14例、右中2例。临床表现为无症状32例、咳嗽8例、胸痛6例、门诊1例无病史,均无发热现象。伴随疾病:浸润性腺癌17例;微小浸润性腺癌20例;良性7例;无伴随疾病3例。影像学(CT):磨玻璃影44例;实性2例,无原始数据1例。吸烟史:其中1例男性有明确吸烟史,其余46例烟史不详。病变:单发40例,占85.1%;多发6例,占12.8%;1例无数据,占2.1%。MPMN是由中等大小的上皮样细胞围绕肺泡腔排列,呈小簇状、漩涡状填充式生长,常伴随肺间质小血管,这些细胞与正常的蛛网膜细胞和脑膜瘤细胞相似,形态学温和,细胞大小中等,呈短梭形或椭圆形,细胞质丰富、嗜酸性,核染色质细腻,核仁不明显,部分细胞可见核内包涵体,Ki-67增殖指数均较低(<2%)。结论MPMN多发于肺下叶,常伴发肺腺癌(78.8%),PR阳性表达率较高(100%),对MPMN目前组织起源情况进行文献学习,明确该病变尚待进一步深入学习研究。
Objective To study the clinical pathological features of minute pulmonary meningothelial-like nodules(MPMN).Methods In this study,47 cases of MPMN which were diagnosed by pathology from April 2019 to SeptembeR2022 were collected foRcomparative and statistical analysis of age,sex,location,clinical manifestations,imaging(CT),concomitant disease,single and muti-focus lesions,size of tumoRand so on.Clinical pathological features of MPMN were analyzed via histology,immunohistochemistry,comparison with the identification method of pulmonary meningiomas at the same time.Results The average age was 59.7 of 47 patients who aged from 36 to 80.Location was as following:upper-left(9 cases),lower-left(14 cases),upper-right(8 cases),lower-right(14 cases)and middle-right(2 cases).Clinical manifestationshad asymptomatic infection(32 cases),cough(8 cases),chest pains(6 cases),no medical history(1 outpatient).All these 47 patients had no fever.Concomitant disease had invasive adenocarcinoma(17 cases),micro-invasive adenocarcinoma(20 cases),benign(7 cases),no concomitant disease(3 cases).Imaging(CT)had ground glass opacity(44 cases),solid nodules(2 cases),no original data(1 case).Smoking history was that one male had a definite smoking history while the otheR46 were unknown.Lesions were single(40 cases accounting foR85.1%),multi-focus(6 cases accounting foR12.8%),one case with no data,accounting foR2.1%.MPMN was composed of medium-sized epithelioid cells arranged around the alveolus cavity,which grow in small clusters and swirls,often accompanied by small pulmonary interstitial blood vessels.These cells,with mild morphology,medium size,short spindle-shape oRoval shape,were similaRto normal arachnoid cells and meningiomas cells.They had abundant cytoplasm and were acidophilic with delicate nucleaRchromatin and obscure nucleolus.IntranucleaRinclusion body could be found in some cells,and Ki-67 proliferation index(<2%)was low.Conclusion MPMN is more common in inferioRlobe of lung.Lung adenocarcinoma(78.8%)would be often associated wit
作者
徐闵
杨旭丹
钱欢
段国强
张容
Xu Min;Yang Xu-dang;Qian Huan(Department of Pathology,Cangxi County People′s Hospital,Guangyuan,Sichuan 628400;Department of Pathology,Sichuan Academy of Medical Sciences&Sichuan Provincial People′s Hospital,Chengdu,Sichuan 610072;Department of Pathology,the First People′s Hospital of Guangyuan,Guangyuan,Sichuan 628017,China.)
出处
《四川医学》
CAS
2024年第5期522-526,共5页
Sichuan Medical Journal
关键词
肺
微小脑膜上皮样结节
肺原发性脑膜瘤
良性病变
lung
minute pulmonary meningothelial-like nodules
primary pulmonary meningioma
benign lesion
