%0 Journal Article
%T 肺腺纤维瘤4例临床病理分析并文献复习
%A 李丹　丁莉　林东亮　赵涵　赵鹏　邢晓明
%J -
%D 2020
%R 10.13362/j.jpmed.202001009
%X 摘要 目的　总结肺腺纤维瘤镜下组织形态学，免疫组织化学特点及鉴别诊断要点，以提高病理医师对此种肿瘤的认识。 方法　回顾性分析4例肺腺纤维瘤患者的临床特征及肿瘤形态学特点、免疫表型，并复习相关文献。 结果　4例肺腺纤维瘤患者中男、女各2例；其中左肺下叶2例，左肺上叶1例，右肺下叶1例；年龄40～67岁；肿瘤大小1.0～3.0 cm。1例患者表现为胸痛，另外3例患者无临床症状。肉眼观肿瘤呈结节状。镜下可见上皮及梭形的间叶成分，可见叶状结构。上皮成分由支气管型上皮或肺泡上皮构成，梭形的间叶性肿瘤细胞类似于纤维细胞及纤维母细胞。免疫组织化学显示所有病例梭形纤维样肿瘤细胞均表达STAT-6、CD34、Bcl-2及CD99，但均未见结蛋白及S100蛋白表达。 结论　肺腺纤维瘤是一种罕见肿瘤，与孤立性纤维性肿瘤存在密切联系，病理医生需掌握其组织学、免疫组织化学特点及鉴别诊断要点，从而做出明确诊断。<br>Abstract：Objective　To investigate the microscopic histomorphological and immunohistochemical features of pulmonary adenofibroma and the key points in the differential diagnosis of this disease, and to improve the awareness of this disease among pathologists. Methods　A retrospective analysis was performed for the clinical features, morphological features, and immunophenotype of four patients with pulmonary adenofibroma, and related articles were reviewed. Results　Among the four patients, there were two male and two female patients, with an age of 40-67 years and a tumor size of 1.0-3.0 cm; two patients had lesions located in the left lower lobe of lung, one had lesions located in the left upper lobe, and one had lesions located in the right lower lobe. One patient had the clinical manifestation of chest pain, while the other three patients had no clinical symptoms. Gross observation showed nodular tumor, and microscopic observation showed epithelial and fusiform mesenchymal components with lobular structures. The epithelial components were composed of bronchial epithelium or alveolar epithelium, and the fusiform mesenchymal tumor cells were similar to fibrocytes and fibroblasts. Immunohistochemistry showed the expression of STAT-6, CD34, Bcl-2, and CD99 in the fusiform tumor cells, while there was no expression of desmin or S100 protein. Conclusion　Pulmonary adenofibroma is a rare tumor and is closely associated with solitary fibrous tumor. Pathologists should grasp the histological and immunohistochemical features of pulmonary adenofibroma and the key points in the differential diagnosis of this disease, so as to give a definite diagnosis
%K 肺肿瘤
%K 腺纤维瘤
%K 免疫组织化学
%K 组织学
%K 病理学
%K 诊断
%K 鉴别<br>Lung neoplasms
%K Adenofibroma
%K Immunohistochemistry
%K Histology
%K Pathology
%K Diagnosis
%K differential
%U http://jpmed.qdu.edu.cn/CN/10.13362/j.jpmed.202001009