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胸膜肿瘤的组织形态学和免疫组织化学分析

Histomorphological and Immunohistochemical Analysis of Pleural Neoplasms.

作者信息

Venkatachala Sandhya, Shivakumar Swarna, Prabhu Meganathan, Padilu Ramya

机构信息

Consultant Pathologist, Apollo Hospitals Bangalore, Bangalore, India.

Registrar Pathology, Apollo Hospitals, Bangalore, Bangalore, India.

出版信息

Iran J Pathol. 2018 Spring;13(2):196-204. Epub 2018 Jul 17.

PMID:30697290
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6339503/
Abstract

BACKGROUND & OBJECTIVE: Primary pleural neoplasms are rare entities compared with the pleural involvement by metastatic carcinoma.The current study aimed at investigating the complete spectrum of pleural neoplasms and differentiating between them with the aid of immunohistochemistry (IHC).

METHODS

Consecutive pleural biopsy specimens positive for a neoplasm, both primary and metastatic, were included in the study. Diagnosis or a differential diagnosis was suggested on histopathology confirmed by a panel of IHC markers such ascytokeratin(AE1/AE3), epithelial membrane antigen (EMA),vimentin, calretinin, CD34, CD99, SMA,bcl2, S100, CK7,CK20,TTF1,GCDFP, HMB45, LCA, synapto-physin, chromogranin, and naspsin.

RESULTS

A total of 35 cases of pleural neoplasms included 15 (42.9%) primary pleural neoplasms and 20 (57.1%) metastatic carcinoma. Synovial sarcoma, malignant mesothelioma (MM), and solitary fibrous tumor (SFT) accounted for 14.2%,11.4%, and 8.5% of metastatic cases, respectively. Epithelioid sarcoma(ES), neuroendocrine carcinoma, and inflammatory myofibroblastic tumor were less common, each contributing to 2.9% of pleural neoplasms. Among the 20 cases of metastatic carcinoma, 13 were from the lung and 7 from the breast. Lung neoplasms metastasizing to the pleura were adenocarcinoma (n=12) and atypical carcinoid (n=1).

CONCLUSION

Analysis of histopathological pattern along with a panel of appropriate IHC markers distinguished the rare entities of pleural neoplasms essential to determine the prognosis and treatment modality.

摘要

背景与目的

与转移性癌累及胸膜相比，原发性胸膜肿瘤较为罕见。本研究旨在借助免疫组织化学（IHC）研究胸膜肿瘤的完整谱系并对其进行鉴别。

方法

本研究纳入了连续的原发性和转移性肿瘤阳性的胸膜活检标本。通过一组免疫组化标志物（如细胞角蛋白[AE1/AE3]、上皮膜抗原[EMA]、波形蛋白、钙视网膜蛋白、CD34、CD99、平滑肌肌动蛋白、bcl2、S100、CK7、CK20、甲状腺转录因子1、GCDFP、HMB45、淋巴细胞共同抗原、突触素、嗜铬粒蛋白和胃蛋白酶）证实的组织病理学结果，提出诊断或鉴别诊断。

结果

总共35例胸膜肿瘤包括15例（42.9%）原发性胸膜肿瘤和20例（57.1%）转移性癌。滑膜肉瘤、恶性间皮瘤（MM）和孤立性纤维性肿瘤（SFT）分别占转移性病例的14.2%、11.4%和8.5%。上皮样肉瘤（ES）、神经内分泌癌和炎性肌纤维母细胞瘤较少见，各占胸膜肿瘤的2.9%。在20例转移性癌中，13例来自肺，7例来自乳腺。转移至胸膜的肺肿瘤为腺癌（n = 12）和非典型类癌（n = 1）。

结论

分析组织病理学模式并结合一组合适的免疫组化标志物，可鉴别胸膜肿瘤的罕见类型，这对于确定预后和治疗方式至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9eac/6339503/4950f3d28aea/ijp-13-196-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9eac/6339503/73301ad3b24c/ijp-13-196-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9eac/6339503/aa589a9a9a14/ijp-13-196-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9eac/6339503/17b97974f780/ijp-13-196-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9eac/6339503/a1252a6d5b78/ijp-13-196-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9eac/6339503/4950f3d28aea/ijp-13-196-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9eac/6339503/73301ad3b24c/ijp-13-196-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9eac/6339503/aa589a9a9a14/ijp-13-196-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9eac/6339503/17b97974f780/ijp-13-196-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9eac/6339503/a1252a6d5b78/ijp-13-196-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9eac/6339503/4950f3d28aea/ijp-13-196-g005.jpg

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