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目的探讨气管恶性潜能未定血管球瘤的病理学特征及诊断、鉴别诊断。方法对1例气管恶性潜能未定血管球瘤的活检、术中冷冻及根治术标本进行光镜观察及免疫组化标记,并结合临床资料复习文献。结果肿瘤位于右肺上叶支气管开口处;镜下见肿瘤侵及气管黏膜层及黏膜下层,瘤细胞呈巢状分布、较一致,呈卵圆形及多角形,胞质嗜酸性到透明状,细胞核位于中央,密集围绕血管。免疫组化:肿瘤细胞vimentin和SMA(),EMA、CK、CK5、CK7、CK34BE12、TTF-1、CD31、CD34、desmin、S-100、Syn、CgA、NSE、bcl-2、ALK和GFAP均(-)。网状纤维染色示网状纤维围绕单个瘤细胞。结论发生于肺组织的血管球瘤非常罕见,活检及术中冷冻诊断困难。组织病理学特征及免疫组化标记是其主要的诊断依据。
Objective To investigate the pathological features, diagnosis and differential diagnosis of untreated tracheal malignant. Methods The biopsy, intraoperative frozen and radical operation specimens of 1 untreated tracheal malignant potential glomus tumor were observed by light microscopy and immunohistochemical markers, and the clinical data were reviewed. Results The tumor was located at the opening of the upper lobe of bronchus in the right lung. The tumors invaded the tracheal mucosa and submucosa microscopically. The neoplasm was nested in the shape of oval and polygons. The cytoplasm was eosinophilic and transparent. Nucleus located in the center, densely surrounded by blood vessels. Immunohistochemistry: Vimentin and SMA (), EMA, CK, CK5, CK7, CK34BE12, TTF-1, CD31, CD34, desmin, S-100, Syn, CgA, NSE, bcl-2, ALK and GFAP all(-). Reticulated fibers show reticular fibers surrounding individual tumor cells. Conclusion The occurrence of glomus tumors in lung is very rare, biopsy and intraoperative cryogenic diagnosis difficult. Histopathological features and immunohistochemical markers are the main diagnostic criteria.