目的:探讨肺髓脂肪瘤的临床病理特点、诊断、鉴别诊断及肿瘤发生的来源.方法:复习1例肺髓脂肪瘤的临床资料,行组织学和免疫组织化学观察.结果:63岁患者CT强化扫描示左肺主支气管内一类圆形不均匀密度肿物,边缘光整.大体检查:肿瘤2 cm×1 cm×0.5 cm大小,切面灰白或灰黄色,质地不均,部分区域质硬如骨样组织.光镜显示:低倍镜见骨小梁组织环形围绕脂肪和造血样组织,局灶可见软骨组织.高倍镜见粒、红、巨核细胞系,三系细胞形态无异常.免疫组织化学染色显示:髓细胞髓过氧化物酶(+),巨核细胞CD61(+).结论:肺髓脂肪瘤非常罕见,确诊依赖病理学检查,形态学典型,认识该疾病有助于避免临床影像学的误诊.%Objective: To investigate the clinicopathologic features, diagnosis, differential diagnosis and tumor occurring sources of lung myelolipoma. Methods: Clinical data and histological and immunohistochemical observation were reviewed in a case of lung myelolipoma. Results: Enhanced CT scan showed a circular mass with uneven density and smooth edges in the left lung main bronchus of a 63-year-old male. Grossly, the tumor measured 2 cm×l cm×0.5 cm. The cut surface disclosed gray and yellow areas, partly as hard as bone tissue, with uneven texture. Light microscopy showed hematopoietic elements admixed with adipose tissue and, focally, with cartilage tissue, and surrounded by a thin layer of trabecular bone. High magnification view showed myeloid, erythroid and megakaryocytic cells; there was no abnormality of cell morphology in the trilineage hematopoietic cells. Immunohistochemistry showed MPO- and CD61- positive for myeloid and megakaryocytic cell, respectively. Conclusion: Pulmonary myelolipoma is very rare. Definite diagnosis depends on typical morphology as revealed by histopathological examination, which may be useful to avoid clinical radiologic misdiagnosis.
展开▼
