摘要
目的探讨富于细胞性血管脂肪瘤的临床病理学特点、免疫学表型和鉴别诊断。方法回顾性复习2例富于细胞性血管脂肪瘤的临床资料和组织学形态,行网状纤维染色,并采用CD31、CD34、FⅧRAg、UEA-1、α-SMA和vimentin等抗体进行免疫组化标记(EnVision法)。结果患者均为男性,年龄分别为38岁和33岁。临床上分别表现为左上臂皮下(例1)、躯干和四肢皮下(例2)多发性小结节,部分结节有疼痛感和触痛感。大体上,结节均有包膜,直径为1～1.5cm。镜下,例1中的1枚结节呈经典的血管脂肪瘤形态,另2枚结节主要由大量的血管组成,而脂肪组织较少(<5%)。网状纤维染色清晰显示丰富的血管结构。部分小血管内可见纤维素性血栓。例2中的2枚结节主要由大量的血管和丰富的梭形间质细胞组成,脂肪组织仅占5%和10%。免疫组化标记显示,富于小血管的区域弥漫强阳性表达CD31、CD34、FⅧRAg、UEA-1和α-SMA,血管之间的梭形间质细胞主要表达vimentin。结论富于细胞血管脂肪瘤是血管脂肪瘤的一种极为罕见的亚型,可被误诊为梭形细胞脂肪瘤、梭形细胞血管瘤、富于细胞性血管瘤和Kaposi肉瘤等肿瘤。
Purpose To analyze the clinieopathologic features and immunophenotype of cellular angiolipoma with emphasis on differen- tial diagnosis. Methods To report two cases of cellular angiolipoma with an immunohistochemical study. Results The both patients were young males with age of 38 and 33 years, respectively. Clinically, Case 1 presented as three separated nodules in the subeutis of the left upper arm with a period of 2 months and Case 2 presented as multiple small nodules on the trunk and extremities with a six months history. Some of the nodules were siightly painful anti tender. There was no family history found. Local excisions of the all-3 nodules in Case 1 and 2 representative nodules in Case 2, were performed. Grossly, the excised nodules were all encapsulated and ranged from 1.0 cm to 1.5 cm in a maximum diameter, Microscopically, in Case 1, a nodule of conventional angiolipoma was observed. The other two nodules were composed of numerous blood vessels with only a minimal amount of adipose tissue（ 〈5% ）. Reticulin staining showed rich network of blood vessels,some of which contained fibrin thrombi. In the nodules of Case 2 ,apart from abundant small thin walled blood vessels, there were also prominent＇interstitial spindle cells. The adipose component comprised only 5% and 10% respectively. Immunohistochemically,the vascular areas stained strongly for CD34,CD31 ,FⅧRAg,UEA-1 ,and α-SMA,whereas the spindle cells were mostly positive for vimentin. Condusions Cellular angiolipoma is a rare but distinctive variant of angiolipoma. It may be misinterpreted as a variety of lesions,such as spindle cells lipoma, spindle cell hamangioma, cellular hemangioma or Kaposi＇s sarcoma.
出处
《临床与实验病理学杂志》
CAS
CSCD
北大核心
2008年第1期62-66,共5页
Chinese Journal of Clinical and Experimental Pathology
