不消退型先天性血管瘤与婴幼儿血管瘤的病理比较

目的 比较研究不消退型先天性血管瘤(noninvoluting congenital hemangioma,NICH)与婴幼儿血管瘤(infantile hemangioma,IH)的病理特征,检测葡萄糖转运蛋白-1(Glut-1)的表达,探讨NICH的病理结构与病程发展的关系.方法 2005年1月至2010年8月,收集13例NICH,13例增殖期IH和13例消退期IH临床标本,采用HE染色和免疫组化染色方法,比较NICH、增殖期IH和消退期IH的病理结构以及Glut-1的表达.结果 HE染色显示,NICH瘤体呈规则的小叶结构,小叶被丰富的纤维组织包绕,小叶内微血管管径较大,小叶内血管壁完整,内皮细胞罕有增殖和凋亡.IH病变呈现从增殖到消退改变,微血管管径较小,血管壁不完整,周细胞扁平,血管内皮细胞和间质细胞可见增殖和凋亡.NICH中不表达Glut-1,增殖期IH肿瘤内皮细胞中Glut-1表达阳性,消退期IH中Glut-1表达阴性或弱阳性.结论 NICH是一种具有低增殖性的血管瘤,病理结构稳定,与增生期IH血管内皮细胞的增殖性具有明显的不同;Glut-1可以作为鉴别NICH和增殖期IH的可靠抗原标记.

Abstract：

Objective To distinguish noninvoluting congenital hemangioma (NICH) and infantile hemangioma ( IH ) by comparing the pathological structure and marker antigen expression. Methods From Jan. 2005 to Aug. 2010,39 paraffin-embedded samples, including 13 cases of NICH, 13 cases of proliferating IH and 13 cases of involuting IH, were collected from operation. Hematoxylin-eosin staining was used to observe the pathological structure. Immunohistochemical analysis was also performed to investigate the expression of Glut-1. Results The lobules of capillaries were well-defined in NICH. The lobules were surrounded by abundant fibrous tissue. The capillaries were often large and integrity in NICH.There were few mitosis and apoptosis in endothelial cells and stromal cells in NICH. While in IH, the pathologic findings were totally different. Immunochemistry revealed that the Glut-1 was expressed in endothelial cells of IH, but not in NICH. Conclusions NICH has a steady histologic structure and low proliferation, while the endothelial cells in proliferative IH has a high proliferation. Glut-1 can be used as the reliable marker antigen for differential diagnosis of NICH and proliferative infantile hemangiomas.

Comparative study on pathology of noninvoluting congenital hemangioma and infantile hemangioma

Objective To distinguish noninvoluting congenital hemangioma (NICH) and infantile hemangioma ( IH ) by comparing the pathological structure and marker antigen expression. Methods From Jan. 2005 to Aug. 2010,39 paraffin-embedded samples, including 13 cases of NICH, 13 cases of proliferating IH and 13 cases of involuting IH, were collected from operation. Hematoxylin-eosin staining was used to observe the pathological structure. Immunohistochemical analysis was also performed to investigate the expression of Glut-1. Results The lobules of capillaries were well-defined in NICH. The lobules were surrounded by abundant fibrous tissue. The capillaries were often large and integrity in NICH.There were few mitosis and apoptosis in endothelial cells and stromal cells in NICH. While in IH, the pathologic findings were totally different. Immunochemistry revealed that the Glut-1 was expressed in endothelial cells of IH, but not in NICH. Conclusions NICH has a steady histologic structure and low proliferation, while the endothelial cells in proliferative IH has a high proliferation. Glut-1 can be used as the reliable marker antigen for differential diagnosis of NICH and proliferative infantile hemangiomas.