摘要
目的:探讨肺良性转移性平滑肌瘤(PBML)的组织发生和生物学性质。方法:对1例PBML的肺活检组织进行光镜和电镜观察以及免疫组化研究。结果:中年女性患者,有子宫平滑肌瘤病史。胸部CT显示双肺多发性结节影。巨检:胸膜下和肺内散在灰白色结节,直径0 2至0 4cm不等,边界清楚,无包膜。光镜观察:瘤细胞呈梭形,弥漫排列,其间有柱状上皮构成的腺样结构,分化成熟。免疫组化:梭形瘤细胞表达vimentin、desmin和平滑肌肌动蛋白,不表达CK、EMA、S 100、NSE和嗜铬素A,腺样结构表达甲状腺转录因子 1。超微结构显示梭形瘤细胞分化好,胞质内有肌丝和扩张的粗面内质网,肌丝间有密体,质膜下有密斑,细胞外有大量的胶原纤维。结论:PBML的梭形瘤细胞似分化成熟的平滑肌细胞和肌纤维母细胞,腺样结构起源于呼吸上皮,提示该瘤实为原发于肺的多发性纤维平滑肌瘤性错构瘤。
Objective:To investigate the histogenesis and biologic behavior of pulmonary benign metastasizing leiomyoma (PBML). Methods:The lung biopsy of a patient with PBML was observed under the light microscope(LM) and electron microscope(EM), and examined by immunohistochemistry. Results:The patient was a middle-age female and had a history of the uterus leiomyoma. The chest computer tomograghy showed multiple nodule shadows in both lungs. The gross appearance of the specimen showed multiple nodules of 0.2～0.4 cm in diameter, gray in color and clear boundary without capsule. The histological examination showed the tumour cells were fusiform, scattered and well-differentiated, and glandular structures could be seen between these cells. Fusiform cells were stained positive with vimentin, desmin and smooth muscle actin(SMA)but not with cytokeratin(CK), epithelial membrane antigen(EMA), S-100 protein, neuron specific endolase(NSE)and chromogranin A, and thyroid transcription factor-1(TTF-1) was stained positive in the glandular structure. The ultrastructure of fusiform tumour cells showed myofilaments, dilated rough endoplasic reticulum and dense bodies in the cytoplasm some dense patchs of cytoplamic membrane were seen. A number of collagen fibers existed in the extra-cellular space. Conclusion:The fusiform cells of PBML seem to be well-differentiated smooth muscle cells and myofibroblast. The glandular structure comes from the respiratory epithelium. It is suggested that the PBML may be the fibroleiomyomatous hamartoma originated from pulmonary.
出处
《电子显微学报》
CAS
CSCD
北大核心
2004年第1期55-59,共5页
Journal of Chinese Electron Microscopy Society
