4 例非经典型肺纤毛黏液结节性乳头状肿瘤的临床病理分析
| 作者: |
1袁晓露,
2王兆宇,
3徐柳,
1刘原,
1吴龙云,
4魏建国
1 岳阳市一人民医院病理科，湖南 岳阳 414000 2 舟山市舟山医院病理科，浙江 舟山 316000 3 济南市人民医院病理科，济南 271199 4 绍兴市人民医院病理科，浙江 绍兴 312000 |
| 通讯: |
魏建国
Email: mickmouse88@163.com |
| DOI: | 10.3978/j.issn.2095-6959.2019.07.038 |
| 基金: | 浙江省绍兴市公益性技术应用研究计划项目 (2017B70020)。 |
摘要
探讨非经典型肺纤毛黏液结节性乳头状肿瘤(ciliated muconodular papillar y tumors，CMPT)的临床特点、病理学特征、免疫表型和诊断中的常见问题。搜集的4例非经典型CMPT中，男1例，女3例。CT显示为肺外周性小结节，最大径为0.6~1.0 cm。镜下肿瘤境界清楚，缺乏乳头状结构，肿瘤基底细胞均完整且连续，腺体腔内被覆比例不等的非纤毛立方细胞和黏液细胞。所有病例均难以找到核分裂象以及坏死。免疫组织化学显示肿瘤细胞表达p63，TTF-1，NapsinA，CEA， CK7，Ki-67增殖指数小于5%。随访患者2~20个月，均未见肿瘤复发。非经典型CMPT显示良性发病经过，在临床表现、影像学特点与CMPT相似，属于一类病变家族，它极大地扩展了CMPT的形态学谱系，但更为合适的肿瘤命名还有待商榷。
关键词：
非经典型；肺纤毛黏液结节性乳头状肿瘤；病理特点；免疫表型
Clinicopathological analysis of 4 cases of non-classic ciliated muconodular papillary tumors
CorrespondingAuthor: WEI Jianguo Email: mickmouse88@163.com
DOI: 10.3978/j.issn.2095-6959.2019.07.038
Foundation: This work was supported by Shaoxing Public Welfare Technology Application Research Project of Zhejiang Province, China (2017B70020).
Abstract
To investigate the clinical characteristics, pathological features, immunophenotype and common problems in diagnose of non-classic ciliated muconodular papillary tumors (CMPT). The four cases of patients included one male and three females. CT scan showed a small peripheral pulmonary nodule with a maximum diameter from 0.6 to 1.0 cm. Microscopically, four non-classical CMPT had clear boundaries and lacking a papillary structure. The basal cells of the tumor glands were intact and continuous, and the non-cilia cubes and mucous cells of the glandular cavity were covered in different proportions. It was difficult to find mitotic figures and necrosis in all cases. Immunohistochemistry results showed that tumor cells expressed p63, TTF-1, NapsinA, CEA, CK7, and the proliferation index of Ki-67 was less than 5%. No recurrence of the tumor was observed after 2–20 months of follow-up. Non-classical CMPT showed benign course, similar in clinical manifestations and imaging features to CMPT. They belong to a family of lesions, which greatly expanded the morphological lineage of CMPT, but the more appropriate tumor naming remains to be discussed.
Keywords：
non-classic; ciliated muconodular papillary tumor; pathological characteristics; immunophenotype