摘要
目的观察间皮性/单核细胞性偶发性心脏赘生物(mesothelial/monocytic incidental cardiac excrescences,MICE)的临床病理学特征、免疫表型并复习文献,以提高对此罕见病变的诊断和鉴别诊断。方法回顾性分析文献报道的43例MICE和作者医院1例MICE的临床资料、组织学特征及免疫表型。结果本文及文献报道共44例,其中男性23例,女性21例,中位年龄61.5岁(5-80岁);发生部位包括心腔27例、心包10例、升主动脉内2例、升主动脉外周1例、腹腔动脉1例、胸膜1例、腹腔1例、另1例部位无法确定;20例患者既往有心导管术史;32例通过心瓣膜置换或修复术从而被发现。组织学主要由呈片状分布的组织样细胞构成,其间见呈条索状、管状、乳头状的上皮样细胞,混杂有不等量的炎细胞和纤维素。免疫表型:组织样细胞表达CD68、LCA等组织细胞表型;间皮样细胞表达CKpan、CK5/6、MC、calretinin等指标,证实病变主要由组织细胞和间皮细胞构成。44例患者中20例获得随访信息,无复发报道。结论 MICE是罕见的良性病变,易误诊为转移癌或其他肿瘤,了解这一病变的组织学特征和免疫表型能够对其进行诊断和鉴别诊断。
Objective To summarize the clinicopathological features of mesothelial/monocytic incidental cardiac excrescences （MICE） for enhancing the cognition and diagnosis of the disease.Methods One case of MICE was observed with clinical findings,histopathology and immunohistochemistry,and the clinical and pathological data of 43 cases from the PubMed were also reviewed.Results There were 44 cases in the literature including the present case,23 male and 21 female,aged 5-80 years,with a median of 6 1.5 years.The examined specimens were mainly from the cardiac chambers （27/44） and the pericardial sac （10/44）,followed by the ascending aorta,celiac artery,pleura and the abdominal cavity.Twenty cases had a previous history of cardiac catheterization.The MICE was found due to valve replacement or repair in 32 of 44 cases.Histologically,the lesion was mainly composed of two types of cells：clusters of numerous histiocytoid cells and cord,papillary or gland-like arranged epithelial-like cells,admixed with inflammatory cells and fibrin.The histiocytoid cells were positive for CD68,LCA.The epithelial-like cells were positive for CKpan,CK5/6,MC,calretinin.Information on the follow-up of patients was available in 20 cases including the present case,and there was no evidence of recurrence in these patients.Conclusion MICE is a rare benign lesion which may be misdiagnosed as metastatic carcinoma or other tumors.Recognition of the histological feature and immunophenotype of this entity is helpful for diagnosis and differential diagnosis.
出处
《山西医科大学学报》
CAS
2014年第11期1053-1057,1118,共6页
Journal of Shanxi Medical University
基金
安徽省卫生厅科研基金资助项目(09C232)
