肺门淋巴结血管瘤 1 例报告。
Hemangioma in a pulmonary hilar lymph node: case report.
机构信息
Department of General Thoracic Surgery, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.
出版信息
World J Surg Oncol. 2011 Jan 26;9:8. doi: 10.1186/1477-7819-9-8.
BACKGROUND
Different types of vascular proliferation may occur in lymph nodes, but hemangiomas in lymph nodes are extremely rare.
CASE PRESENTATION
A 73-year-old man was found to have a 15-mm nodular shadow in the left lung on computed tomography, and bronchoscopic brush cytology yielded a diagnosis of squamous cell carcinoma. Chest computed tomography showed no evidence of hilar or mediastinal lymphadenopathy. Left lower lobectomy with hilar and mediastinal lymph node dissection was performed. Postoperative histopathological examination revealed squamous cell carcinoma and no lymph node metastasis. On the other hand, a lobar bronchial lymph node presented a small lesion showing the dense proliferation of capillary blood vessels with elastic change. Immunohistochemically, the lesion was positive for factor VIII and CD34, leading to a diagnosis of primary hemangioma of the lymph node.
CONCLUSION
To our knowledge, this is the first case reported in the literature of hemangioma in a pulmonary hilar lymph node. Intranodal hemangioma needs to be differentiated from malignant vascular tumors.
背景
淋巴结中可能会发生不同类型的血管增生，但淋巴结中的血管瘤极为罕见。
病例介绍
一名 73 岁男性在胸部计算机断层扫描中发现左肺有一个 15 毫米的结节状阴影，支气管镜刷检细胞学诊断为鳞状细胞癌。胸部计算机断层扫描未显示肺门或纵隔淋巴结肿大。行左肺下叶切除术及肺门和纵隔淋巴结清扫术。术后组织病理学检查显示鳞状细胞癌且无淋巴结转移。另一方面，一个肺叶支气管淋巴结呈现出一个小病变，表现为毛细血管密集增生并伴有弹性变化。免疫组织化学检查显示病变 VIII 因子和 CD34 阳性，诊断为淋巴结原发性血管瘤。
结论
据我们所知，这是文献中首例肺门淋巴结血管瘤的病例报告。需要将淋巴结内血管瘤与恶性血管肿瘤相鉴别。
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