Zhou Y M, Dai J, Xu X X, Zhu Y M, Jiang G N, Zhang L P
Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University, Shanghai 200433, China.
Department of Pathology, Shanghai Pulmonary Hospital, Tongji University, Shanghai 200433, China.
Zhonghua Wai Ke Za Zhi. 2021 Jan 1;59(1):66-70. doi: 10.3760/cma.j.cn112139-20200821-00658.
To examine the clinical features, diagnostic and therapeutic strategy of solitary pulmonary capillary hemangioma (SPCH). The data of 10 SPCH cases who underwent surgical operations from June 2017 to June 2020 in were retrospectively reviewed. There were 4 males and 6 females, aged (49.8±13.6) years (range: 26 to 66 years). The clinical manifestations, imaging manifestations, treatment and pathological diagnosis were analyzed. All patients were asymptomatic, and all nodules were detected by CT. The size of nodule was (14.9±5.8) mm (range: 8 to 30 mm). Seven of 10 cases showed the mixed ground-glass nodule appearance and 2 cases showed solid nodule and 1 case showed cystic solid nodule appearance in CT findings. The growth speed was very slow. The follow-up time was 4.5(21.5) months before surgery. Histologically, SPCH manifested as a solitary lesion composed of densely proliferating and dilated capillaries without cytologic atypia within the alveolar septa. Immunohistochemically, capillaries of SPCH uniformly expressed endothelial markers, such as CD31, CD34. The patients were followed up for 15.0(22.0) months after surgery and all recovered well. SPCH is probably an unrecognized benign capillary proliferative disease. SPCH lesions mimic early lung cancer on CT as mixed ground-glass nodule, may be misdiagnosed as other nonspecific benign lesions. With careful histologic examination, SPCH can be successfully diagnosed using CD34 or CD31 immunohistochemistry staining.
探讨孤立性肺毛细血管瘤(SPCH)的临床特征、诊断及治疗策略。回顾性分析2017年6月至2020年6月期间10例接受手术治疗的SPCH患者资料。其中男性4例,女性6例,年龄(49.8±13.6)岁(范围:26至66岁)。分析其临床表现、影像学表现、治疗及病理诊断。所有患者均无症状,结节均由CT检出。结节大小为(14.9±5.8)mm(范围:8至30 mm)。CT表现中,10例中有7例呈混合磨玻璃结节样,2例呈实性结节,1例呈囊实性结节。生长速度非常缓慢。术前随访时间为4.5(21.5)个月。组织学上,SPCH表现为孤立性病变,由肺泡间隔内密集增生和扩张的毛细血管组成,无细胞异型性。免疫组化显示,SPCH的毛细血管均匀表达内皮标志物,如CD31、CD34。术后随访15.0(22.0)个月,所有患者恢复良好。SPCH可能是一种未被认识的良性毛细血管增生性疾病。SPCH病变在CT上表现为混合磨玻璃结节,类似早期肺癌,可能被误诊为其他非特异性良性病变。通过仔细的组织学检查,使用CD34或CD31免疫组化染色可成功诊断SPCH。