Koss M N, Hochholzer L, Moran C A
Department of Pulmonary and Mediastinal Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000, USA.
Mod Pathol. 1998 Mar;11(3):253-8.
We present two cases of glomus tumors arising within the lung parenchyma. The patients are a 40-year-old man and a 51-year-old man. Clinically, the two men were asymptomatic, and the pulmonary tumor was detected during a routine chest roentgenographic examination. Complete surgical resection of the pulmonary tumors was performed. Grossly, the tumors measured 1.1 and 1.5 cm. in greatest dimension; they were well circumscribed and subpleural. Neither tumor showed evidence of invasion of lung or pleura. Histologically, both tumors had pseudocapsules, lacked invasion of surrounding lung structures, and demonstrated the appearance of the solid/mucohyaline, or "glomus tumor proper" type of neoplasm. This included oval-to-round cells, with central uniform nuclei; variably eosinophilic-to-clear cytoplasm; and well-demarcated cell borders in close proximity to a rich vascular supply showing perivascular fibrosis. Immunohistochemically, both tumors showed diffuse, moderate-to-strong staining for vimentin, muscle-specific actin, and smooth muscle actin. One tumor also showed diffuse strong staining for desmin, whereas the other was negative. Follow-up information obtained from one of the patients revealed that he was alive and well 47 months after surgical resection. Our cases highlight the ubiquitous distribution of glomus tumor and its similar histologic appearance and immunohistochemical profile to soft tissue glomus tumors.
我们报告两例起源于肺实质的血管球瘤病例。患者为一名40岁男性和一名51岁男性。临床上，这两名男性均无症状，肺部肿瘤是在常规胸部X线检查时发现的。对肺部肿瘤进行了完整的手术切除。大体上，肿瘤最大径分别为1.1厘米和1.5厘米；边界清晰，位于胸膜下。两个肿瘤均未显示肺或胸膜受侵的证据。组织学上，两个肿瘤均有假包膜，未侵犯周围肺结构，并表现为实体/黏液透明样，即“典型血管球瘤”类型的肿瘤。这包括椭圆形至圆形细胞，细胞核居中且均匀；胞质呈嗜酸性至透明不等；细胞边界清晰，紧邻丰富的血管供应并伴有血管周围纤维化。免疫组化方面，两个肿瘤均对波形蛋白、肌肉特异性肌动蛋白和平滑肌肌动蛋白呈弥漫性、中度至强阳性染色。其中一个肿瘤对结蛋白也呈弥漫性强阳性染色，而另一个为阴性。从其中一名患者获得的随访信息显示，他在手术切除后47个月仍健在且状况良好。我们的病例突出了血管球瘤的广泛分布及其与软组织血管球瘤相似的组织学表现和免疫组化特征。
