膀胱复合性血管内皮瘤1 例并文献复习
| 作者: |
1潘斌才,
1王春华,
1黄桂芳,
1梁颖雯,
1黄嘉裕,
1徐伟玲,
2郑晓昀,
3李智
1 广东同江医院病理科，广东 佛山 528300 2 广东同江医院放射科，广东 佛山 528300 3 广东省人民医院病理科，广州 510080 |
| 通讯: |
潘斌才
Email: pbc1980@163.com |
| DOI: | 10.3978/j.issn.2095-6959.2019.10.036 |
摘要
复合性血管内皮瘤(composite hemangioendothelioma，CHE)是一种非常罕见的局部侵袭性中间性/交界性血管肿瘤，本文分析研究1例发生于膀胱的CHE病例的临床病理学特征，并结合国内外文献探讨其诊断要点及鉴别诊断。患者女，58岁，膀胱与右侧输尿管下段交界处见一不规则肿物，镜下显示肿物内丰富的血管成分呈浸润性生长，部分表现为毛细血管瘤样、梭形细胞血管瘤及海绵状血管瘤样良性血管肿瘤成分，同时可见上皮样血管内皮瘤及高分化血管肉瘤的区域；免疫组织化学表达CD31，CD34，第八因子相关抗原(FVIII-RAg)等血管标志物，同时灶性表达CD56，Syn神经内分泌抗体；手术后随访6个月，肿瘤未见复发或远处转移。CHE的可变及多种血管瘤成分共存的特征使得临床工作人员在鉴别诊断及判断评估其生物学行为时需强调其独特形态学特征的重要性。
关键词：
复合性血管内皮瘤；膀胱；组织形态学；鉴别诊断
Bladder composite hemangioendothelioma: A case report and literature review
CorrespondingAuthor: PAN Bincai Email: pbc1980@163.com
DOI: 10.3978/j.issn.2095-6959.2019.10.036
Abstract
Composite hemangioendothelioma (CHE) is a very rare local invasive intermediate/boundary vascular tumor. The clinicopathological features of a case of CHE occurred in the bladder were studied by means of histomorphology and immunohistochemistry. The diagnostic criteria and differential diagnosis were analyzed in combination with domestic and foreign literatures. An irregular mass was seen at the junction of the bladder and the lower right ureter in a 58-year-old female patient. Under histological microscopy, the tumor showed infiltrative growth of abundant vascular components, some of which were capillary hemangioma, spindle cell hemangioma and cavernous hemangioma-like benign vascular neoplasms. Epithelioid hemangioendothelioma and well-differentiated hemangiosarcoma were also seen. Immunohistochemical staining showed that tumor cells expressed CD31, CD34, FVIII-RAg and other vascular markers, while focally expressed CD56 and Syn neuroendocrine antibodies. The patient was followed up for six months after surgery, and the tumor showed no recurrence or distant metastasis. The variability of CHE and the coexistence of various hemangioma components made it important to emphasize its unique morphological features in differential diagnosis and in judging and evaluating its biological behavior.
Keywords：
composite hemangioendothelioma; bladder; histomorphology; differential diagnosis