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目的分析气管血管球瘤(glomus tumor,GT)的临床病理特征、诊断与鉴别诊断、治疗及预后。方法对6例气管GT的临床病理和免疫组织化学特征进行回顾性分析,并结合相关文献复习。结果气管GT缺乏特征性临床表现,纤维支气管镜及CT检查示气管内新生物。纤维支气管镜下,肿瘤位于气管黏膜下组织,无包膜,内有大量扩张的薄壁血管。肿瘤细胞围绕血管成片分布,瘤细胞圆形或卵圆形,大小一致,胞质淡染嗜酸性,核仁不明显,未见核分裂象。免疫组织化学显示:Vimentin、SMA均阳性。结论发生于气管的GT非常罕见,由于其缺乏特征性的临床表现及镜下特点而极易误诊为类癌,确诊需在HE形态学的基础上,结合免疫组织化学染色进行诊断及鉴别诊断。
Objective To analyze the clinicopathological characteristics, diagnosis and differential diagnosis, treatment and prognosis of glomus tumor (GT). Methods Six cases of tracheal GT were retrospectively analyzed on the clinicopathological and immunohistochemical features and combined with the related literatures. Results Trachea GT lacks characteristic clinical manifestations, bronchoscopy and CT examination of new endotracheal tubes. Fiberoptic bronchoscopy, the tumor is located in the tracheal submucosal tissue, no capsule, there are a large number of expanded thin-walled vessels. Tumor cells around the blood vessels into a film distribution, tumor cells round or oval, the same size, paleophilic cytoplasm, nucleoli are not obvious, no mitotic. Immunohistochemistry showed: Vimentin, SMA were positive. Conclusion The tracheal GT is very rare. Because of its lack of characteristic clinical manifestations and microscopic features, GT can be easily misdiagnosed as carcinoid. On the basis of HE morphology, diagnosis and differential diagnosis should be based on immunohistochemical staining.