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目的 研究肝血管平滑肌脂肪瘤的临床病理学特点 ,并介绍一种新抗体A10 3的诊断意义。方法 对 10例肝血管平滑肌脂肪瘤的临床资料进行复习 ,并用石蜡切片进行组织化学、免疫组化检测 (包括A10 3) ,其中 3例进行电镜观察。结果 10例AML中 8例女性 ,2例男性 ,平均年龄 4 4岁。临床无症状 ,影像学检查偶然发现。大体上为境界清楚但无包膜的肿块 ;光镜下由三种成分 (厚壁血管、梭形或上皮样平滑肌细胞及脂肪 )混合组成。免疫组化检查瘤细胞均表达A10 3,HMB 4 5及平滑肌标记。随访 10例病人均无复发。结论 血管平滑肌脂肪瘤的三种主要组成成分的比例和分布各异 ,致使组织学形态变化多端。确切的病理诊断还需借助于免疫组化 ,尤其是A10 3对鉴别诊断有重要意义
Objective To study the clinicopathological features of hepatic angiomyolipoma and to introduce the diagnostic significance of a new antibody A10 3 . Methods The clinical data of 10 cases of hepatic angiomyolipoma were reviewed. Paraffin sections were used for histochemical and immunohistochemical detection (including A10 3). Three of them were observed under electron microscope. Results Of the 10 cases of AML, 8 were female and 2 were male, with an average age of 4 years. Clinically asymptomatic, imaging examination was accidentally discovered. It is a clear-cut but non-enveloped mass; it consists of a mixture of three components (thick-walled blood vessels, spindles, or epithelioid smooth muscle cells and fat) under light microscopy. Immunohistochemical examination of tumor cells expressed A10 3, HMB 4 5 and smooth muscle markers. Follow-up of 10 patients had no recurrence. Conclusions The proportions and distribution of the three major components of angiomyolipoma are different, resulting in a variety of histological changes. The exact pathological diagnosis needs immunohistochemistry, especially A10 3 is important for differential diagnosis.