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目的探讨肺间叶性囊性错构瘤的病理诊断及临床病理特点。方法对1例肺间叶性囊性错构瘤的影像学、组织学、免疫组化特征及临床特点进行分析,结合文献讨论其临床病理特征、病理诊断与鉴别诊断。结果患者女性,43岁。右侧自发性气胸出现呼吸困难。CT示双肺多发实性结节及右肺多发囊肿。开胸探查行右肺囊肿及肺结节楔形切除术。镜下病变组织由细胞核占优势的原始间叶细胞构成,其中囊性病变表面被覆正常的呼吸上皮,实性结节内见正常呼吸上皮构成的腺样结构。免疫组化示vimentin、bcl-2、CD10和CD56均弥漫(+),Ki-67指数约1%。术后随访1年,患者一般情况佳。结论肺间叶性囊性错构瘤罕见,易误诊为胸膜型肺母细胞瘤或其他少见肺囊性病变,根据其独特的组织学特征并结合临床特点可做出正确的诊断。
Objective To investigate the pathological diagnosis and clinicopathological features of pulmonary cystic cystic hamartoma. Methods The imaging, histology, immunohistochemical characteristics and clinical features of one case of pulmonary cystic cystadenoma were analyzed. The clinical and pathological features, pathological diagnosis and differential diagnosis were also discussed. Results Female patient, 43 years old. Right spontaneous pneumothorax appeared dyspnea. CT showed multiple solid lung nodules and multiple lung lesions of the right lung. Thoracotomy exploration right lung cysts and pulmonary nodules wedge resection. Microscopic lesions consist of primitive mesenchymal cells predominantly nucleated, of which cystic lesions are covered with normal respiratory epithelia and solid nodules with adenoid structures of normal respiratory epithelium. Immunohistochemistry showed that vimentin, bcl-2, CD10 and CD56 were diffuse (+), Ki-67 index of about 1%. Follow-up 1 year after surgery, patients in general good condition. Conclusions Pulmonary interstitial cystadenomas are rare and easily misdiagnosed as pleuropulmonary blastoma or other rare pulmonary cystic lesions. Correct diagnosis can be made according to their unique histological features and clinical features.