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目的探讨异位错构瘤性胸腺瘤的临床病理特征。方法对1例异位错构瘤性胸腺瘤进行临床病理学及免疫组化分析,并文献复习。结果患者女性,65岁。以胸骨上窝皮下肿块为主要表现。肿瘤有纤维性假包膜,由增生的梭形细胞、上皮细胞及成熟的脂肪组织构成。梭形细胞占主要成分,多呈束状、编织状排列;上皮细胞以非角化性鳞状细胞为主,呈实性的巢状和扩张的囊肿样排列,部分区域腺样分化,衬覆于囊内或呈腺样结构。梭形细胞与上皮细胞有移行。免疫组化:上皮细胞CKpan、EMA、CK5和p63(+),梭形细胞CKpan、CK5、calponin、p63、vimentin和CD34均(+),两者desmin和S-100均(-),Ki-67<1%。结论异位错构瘤性胸腺瘤是一种少见的良性肿瘤,有独特的发病部位和形态学表现,梭形细胞上皮本质的认识是正确诊断和鉴别诊断的关键。
Objective To investigate the clinicopathological features of ectopic hamartoma. Methods One case of ectopic hamartoma was studied by clinicopathological and immunohistochemical analysis and literature review. Results Female patient, 65 years old. To the sternum nest subcutaneous mass as the main performance. The tumor has a fibrous pseudocapsule, which consists of hyperplastic spindle cells, epithelial cells and mature adipose tissue. Fibroblast cells account for the main components, mostly in the shape of a bundle, woven arrangement; epithelial cells to non-keratinized squamous cells, was solid nests and dilated cyst-like arrangement, part of the regional adenoid differentiation, lining In the cyst or adenoid-like structure. Spindle cells and epithelial cells migrate. Immunohistochemistry: CKpan, EMA, CK5 and p63 (+), CKpan, CK5, calponin, p63, vimentin and CD34 were all positive in epithelial cells 67 <1%. Conclusions Heterotopic hamartoma is a rare benign tumor with unique pathogenic sites and morphological features. The understanding of the nature of spindle epithelial cells is the key to correct diagnosis and differential diagnosis.