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孤立性肺毛细血管血管瘤病例:基于冷冻切片分析的病理特征。

Case of solitary pulmonary capillary hemangioma: pathological features based on frozen section analysis.

机构信息

Department of Pathology, Kanagawa Cancer Center, Yokohama, Japan; Department of Thoracic Surgery, Kanagawa Cancer Center, Yokohama, Japan; Department of Surgery, Yokohama City University, Yokohama, Japan.

出版信息

Pathol Int. 2013 Dec;63(12):615-8. doi: 10.1111/pin.12120.

Abstract

Solitary pulmonary capillary hemangioma (SPCH) is a rare benign lung tumor that must be distinguished from small and early lung cancers. Here, we report a case of SPCH for which we performed frozen section diagnosis. The patient was a 55-year-old Japanese woman. Five years before the operation, mixed ground-glass opacity was detected by computed tomography in the left posterior basal segment of the lower lobe (S10). Because the interior tumor density of the ground-glass opacity increased slightly, video-assisted thoracic surgery wedge resection was performed. Frozen section diagnosis revealed a benign tumor without proliferation of atypical epithelial cells. The tumor had narrow alveolar lumens, thickened alveolar septa and a clear boundary separating it from normal lung tissue. The proliferated lumens varied in size and were lined with single layers of flat cells. After the operation, immunohistochemical staining of a paraffin section revealed that the thickened alveolar septa resulted from the proliferation of capillary vessels, the flat cells of which were positive for CD31 and CD34 and negative for podoplanin; the tumor was diagnosed as SPCH. Here, we discuss the pathological features of SPCH on frozen sections with reference to this case and review previous related reports.

摘要

孤立性肺毛细血管血管瘤(SPCH)是一种罕见的良性肺肿瘤,必须与小的早期肺癌区分开来。在此,我们报告了一例 SPCH 的冷冻切片诊断病例。患者为 55 岁日本女性。在手术前 5 年,胸部 CT 检测到左肺下叶后基底段(S10)存在混合磨玻璃密度影。由于磨玻璃密度影的内部肿瘤密度略有增加,因此进行了电视辅助胸腔镜楔形切除术。冷冻切片诊断为良性肿瘤,无非典型上皮细胞增殖。肿瘤的肺泡腔狭窄,肺泡间隔增厚,与正常肺组织分界清楚。增殖的腔大小不一,由单层扁平细胞排列而成。术后石蜡切片免疫组织化学染色显示,增厚的肺泡间隔是由毛细血管增殖引起的,其中扁平细胞 CD31 和 CD34 阳性,podoplanin 阴性;肿瘤被诊断为 SPCH。在此,我们结合该病例并复习以往相关文献,讨论冷冻切片上 SPCH 的病理特征。

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