血管免疫母细胞性淋巴结病及血管免疫母细胞性T细胞淋巴瘤

为了深入调查血管免疫母细胞性淋巴结病（ＡＩＬＤ）和血管免疫母细胞性Ｔ细胞淋巴瘤（ＡＩＴＬ）的临床病理、病变性质诸方面，采用了免疫组化和聚合酶链反应（ＰＣＲ）等方法对５例进行了分析。该５例患者均有全身淋巴结肿大（但直径多小于１ｃｍ），肝脾肿大、发热和多项血液指标改变。ＡＩＴＬ时在ＡＩＬＤ病变背景上出现异型的透明Ｔ细胞浸润为诊断和鉴别依据。５例中４例行ＴＣＲ－β重排分析均呈现克隆性改变。并对４例埃泼斯坦－巴尔病毒（ＥＢＶ）感染情况进行分析，其中３例ＥＢＶＤＮＡ阳性。认为ＡＩＬＤ可能是一种与ＥＢＶ感染相关的瘤前病变，发展为淋巴瘤的比例较高。     

肾脏不典型血管平滑肌脂肪瘤4例报道并文献复习

目的：探讨肾脏不典型血管平滑肌脂肪瘤（ａｔｙｐｉｃａｌ ａｎｇｉｏｍｙｏｌｉｐｏｍａ,ＡＡＭＬ）的临床病理特征。方法：收集４例曾误诊为肾肉瘤样癌或恶纤组的ＡＡＭＬ行光镜、免疫组化观察,并对其中１例和另３例典型ＡＭＬ作电镜观察。结果：ＡＡＭＬ具有以下的病理特点：①肉眼上切面呈棕褐色,可伴有坏死及出血;②光镜下表现为富细胞,主要由胞浆丰富嗜酸性的单核或多核多形性瘤巨细胞和梭形的肉瘤样细胞及胞浆透明成片     

促纤维化小圆细胞肿瘤5例临床病理、免疫组化及电镜观察

目的：观察５例促纤维化小圆细胞肿瘤的临床病理特点,提高对此类肿瘤的认识。方法：常规组织学（ＨＥ）、免疫组化（ＡＢＣ法）和电镜技术检测结合临床资料综合分析。结果：５例中２例多次局部复发,２例在随访中,１例确诊后４个月死亡。该肿瘤组织学特点为肿瘤组织呈单结节或多结节状浸润生长,伴有明显致密的成熟纤维性间质增性,肿瘤细胞主要为大小比较一致的小圆形细胞,呈团状或巢状埋于增生纤维间质中,少数病例部分区域肿瘤     

肿瘤坏死因子α和血管紧张素Ⅱ对心肌细胞的细胞间粘？…

目的：研究肿瘤坏死因子α（ＴＮＦα）和血管紧张素Ⅱ对心肌细胞的细胞间粘附分子－１（ＩＣＡＭ－１）表达的不同影响。方法：运用免疫组化技术和流式细胞仪观察ＴＮＦα和ＡｎｇⅡ对培养的乳鼠心肌细胞ＩＣＡＭ－１表达量的影响。结果Ｌ：ＴＮＦα明显增加心肌细胞ＩＣＡＭ－１表达量,以刺激６ｈ最明显,随时间作用延长表达量减少。ＡｎｇⅡ对培养的心肌细胞ＩＣＡＭ－１表达量无显著作用。结论：ＴＮＦα是调节心肌细胞ＩＣＡＭ     

脑上皮样血管内皮瘤1例及文献复习

目的：探讨脑上皮样血管内皮瘤（ＥＨＥ）的诊断及鉴别诊断。方法：通过ＨＥ、免疫组化及电镜观察１例脑原发性多灶性上皮样血管内皮瘤、并复习文献。结果：肿瘤由排列呈巢状、索状的上皮样细胞组成,胞浆丰富、嗜酸性;内含明显空泡呈“印戒”状,有的空泡内可见红血球,间质含粘液样基质。免疫组化染色显示ＦⅧ、ＣＤ３４、ＣＤ３１、ＵＥＡ－１和ｖｉｍｅｎｔｉｎ阳性;而ＣＫ、ＣＥＡ、ＥＭＡ、ＧＦＡＰ、Ｓ－１００蛋白及Ｍａｃ     

五例粘膜相关淋巴组织淋巴瘤免疫组织化学探讨

五例粘膜相关淋巴组织淋巴瘤免疫组织化学探讨张雅洁，高绪兰，李玉林一、材料和方法５例胃肠道粘膜相关淋巴组织（ＭＡＬＴ）淋巴瘤手术及活检材料，经１０％福马林固定，石蜡包埋后制成３μｍ厚的连续切片，进行病理及免疫组化检测。免疫组化（ＡＢＣ法）用Ｂ细胞标记抗...     

胆管癌对血管和神经周围间隙的侵犯及肿瘤血管生成在浸…

对４０例胆管癌标本切片进行血管内膜下弹力纤维ＶＢ：ＨＥ，ＦⅧＲＡｇ：ＶＢ：Ｈ及ＨＥ染色，结果显示血管侵犯者３１例（７７．５％），表现为４种类型，即血管壁受侵，游离癌细胞侵入，部分栓塞和完全栓塞，肿瘤血管密度（ＴＶＤ）与转移发生明显相关，发生神经周围间隙浸润者共３３例（８２．５％），神经周围浸润指数（ＰＮＩ）与器官或组织转移发生率相关。研究表明，血管和神经周围间隙均是重要的转移途径。肿瘤知管生成是浸     

肾上腺上皮样血管肉瘤的临床病理研究

０２９肾上腺上皮样血管肉瘤的临床病理研究［英］／ＷｅｎｇＢＭ…／／ＡｍＪ．ＳｕｒｇＰａｔｈｏｌ．－１９９４，１８（１）．－６２～７３肾上腺上皮样血管肉瘤（ＡＥＡ）罕见。作者报告９例ＥＡＥ患者的临床病理学特征。ＡＥＡ多发生在５０～６０岁，男性５例，女性...     

14例肝血管平滑肌脂肪瘤病理形态分析

目的 观察肝血管平滑肌脂肪瘤（ＨＡＭＬ）的形态学特点。方法 采用ＨＥ切片、ＰＡＳ糖原和免疫组织化学ＳＰ法染色、电镜观察等对本院１０例及会诊４例ＨＡＭＬ进行研究。结果 １４例ＨＡＭＬ均显示肿瘤细胞围绕血管呈上皮样排列,血管分厚壁及薄壁２种,上皮样细胞分为４种形态,形态与免疫表型有一定相关关系,部分上皮样细胞胞质ＰＡＳ阳性且抗淀粉酶消化,电镜下可见类似前黑色素小体及密体。结论 肌动蛋白、ＨＭＢ４５阳性     

IFN—γ抑制血管成形术后兔血管平滑肌细胞增殖和PDGF—A的表达

目的和方法：采用体外细胞培养，进行氚标胸腺嘧啶核苷（３Ｈ－ＴｄＲ）掺入和原位杂交。结果：发现γ－干扰素（ＩＦＮ－γ）能抑制体外培养新西兰兔血管平滑肌细胞（ＶＳＭＣ）的ＤＮＡ合成和血小板衍化生长因子Ａ链（ＰＤＧＦ－Ａ）的基因表达；整体实验中，用４ＦＦｏｇａｒｔｙ导管气囊拉伤新西兰兔的腹主动脉内皮后，随即连续肌注ＩＦＮ－γ（１６５万Ｕ·ｋｇ１·ｄ１）３天，结果发现肌注ＩＦＮ－γ能明显抑制受损部位ＶＳＭＣ的３Ｈ－ＴｄＲ的标记率及ＰＤＧＦ－Ａ的表达。结论：ＩＦＮ－γ对血管成形术引起的血管挛缩有一定的舒张作用。     

血管肌纤维母细胞瘤临床病理特征

目的：探讨血管肌纤维母细胞瘤的临床病理形态特征及鉴别诊断。方法：对2例血管肌纤维母细胞进行组织病理学、免疫组织化学研究,结合文献资料分析本病的临床表现、病理形态特点及鉴别诊断。结果：血管肌纤维母细胞瘤呈大片黏液背景、丰富薄壁海绵样血管和梭形上皮样细胞即肌纤维母细胞,后者胞质丰富,呈嗜酸性,核卵圆或杆状,两端对称变细或稍钝,瘤细胞分布有明显的疏密区,密集区聚于血管周围,成束或链状排列、疏松区弥散于黏液背景中,且瘤细胞常与胶原纤维伴行。结论：血管肌纤维母细胞瘤为良性肿瘤,好发于女性外生殖器,起源与肌纤维母细胞相关,既向纤维,又向平滑肌分化,且伴有丰富的海绵样薄壁血压和间质黏液变性。     

软组织多形性透明变性血管扩张性肿瘤

目的：探讨软组织多开矿性透明变性血管扩张性肿瘤的临床病理学特点。方法：对２例软组织多形性透明变性血管扩张性肿瘤进行光镜观察和免疫组化检测。结果：１例为５８岁女性,表现为颈部皮下缓慢性生长的肿块;另１例为３１岁男性,表现为右后腹膜内肿块。眼观,肿瘤境界均较清楚,镜检,显示以下三个特征性的形态学改变：（１）呈簇性分布扩张性的薄壁血管;（２）分布于扩张血管之间的多形性瘤细胞;（３）血管壁、血管周围及瘤细     

血管肌纤维母细胞瘤2例报道及文献复习

目的 探讨血管肌纤维母细胞瘤(AMF)的临床病理特征及诊断和鉴别诊断。方法 对2例AMF进行组织学观察和免疫组化S—P法标记，抗体为vimentin、desmin、SMA、S—100蛋白、CD34、ER、PR、CK等。结果 1例为30岁女性，表现为外阴囊肿；1例为51岁男性，表现为腹股沟区精索肿块。眼观：肿瘤境界均清楚；镜检：肿瘤均由相互交错分布的细胞密集区和细胞稀疏区组成，其间血管丰富，多为毛细血管至中等大薄壁血管。瘤细胞成巢或束状围绕血管周围排列。可见红细胞漏出。其中1例尚可见成群分布的脂肪细胞存在。免疫表型：瘤细胞vimentin(2／2)、ER(2／2)、PR(2／2)、SMA(1／2)、CD34(2／2)阳性，SMA(1／2)、S—100蛋白(1／2)灶性阳性，desmin、CK阴性。结论 AMF是一种少见的好发于外阴生殖道的间质肿瘤，可能来源于血管周具有多向分化潜能的干细胞，可向肌纤维母细胞分化。在组织形态上AMF应与侵袭性血管黏液瘤、富细胞性血管纤维瘤、浅表性血管黏液瘤、纤维上皮性间质息肉、梭形细胞脂肪瘤相鉴别。     

Angiomyofibroblastoma of the vulva: A clinicopathologic study of seven cases

A clinicopathologic and immunohistochemical review was made of seven cases of angiomyofibroblastoma. The patients were middle-aged women who had a slowly growing mass, measuring 1.5–6 cm in maximum dimension, located sub-cutaneously in the vulva. The tumors were well-demarcated and characterized by well-vascularized, alternating hyper-cellular and hypocellular edematous areas composed of bland, plump spindle- or oval-shaped stromal cells frequently aggregated around small blood vessels. An epithelioid appearance of the stromal cells was seen in two cases. Immunohistochemically, the stromal cells were consistently positive for vimentin and desmin, but negative for muscle specific actin, a-smooth muscle actin, myosin, cytokeratins, S-100 protein or von Willebrand factor. Ultrastructurally, the plump stromal cells had a small amount of peripherally located rough endoplasmic reticulum, numerous pinocytotic vesicles and abundant intermediate filaments, on which immunogold probes for desmin were localized, whereas fine filaments were few and there were no electron dense plaques. Thus, while the proliferating stromal cells expressed an immunohistochemical profile of peculiar myoid differentiation, ultrastructural findings differed from those of smooth muscle cells or those seen in typical myofibroblasts. At 1–4 years after surgery, there was no evidence of recurrence.     

Vulvovaginal myofibroblastoma: expanding the morphological and immunohistochemical spectrum. A clinicopathologic study of 10 cases

We analyzed the clinicopathologic features of 10 cases of vulvovaginal myofibroblastoma to widen its morphological and immunohistochemical spectrum. Most tumors (8/10 cases) were located in the vagina. The patients' age ranged from 44 to 77 years, and tumor size ranged from 0.4 to 3 cm. Histologically, 5 tumors had the characteristics of vulvovaginal myofibroblastoma. In addition, we identified 3 cases composed of spindle-shaped cells arranged in short fascicles with intervening thick collagen bands, closely reminiscent of mammary myofibroblastoma. Notably, 1 case resembled Sertoli cell tumor, sclerosing type, because of its predominant cord-like arrangement. In another case, there were highly cellular areas composed of uniform-packed, rounded cells that, at low magnification, looked like a malignant "small round blue cell tumor." A variably thick band of native connective tissue separated tumors from the overlying squamous epithelium even if, in 3 cases, tumor cells extended up to the epithelium. In 7 cases, a variable number of vessels showed perivascular hyalinization. Only rare mitotic figures were identified. All tumors were diffusely positive for vimentin, desmin, and CD99. A variable staining intensity was observed for CD34, Bcl-2, B-cell lymphoma 2 (Bcl-2) CD10, estrogen receptor, and progesterone receptor in most cases, but none expressed α-smooth muscle actin. We emphasize that vulvovaginal myofibroblastoma encompasses a morphological spectrum wider than previously described. The overlapping morphological and immunohistochemical features of vulvovaginal and mammary myofibroblastomas led us to speculate that these are related entities with morphological variations on a common basic theme likely dependent on anatomical location.     

Bile canaliculi-like lumina in fibrolamellar carcinoma of the liver: A light- and electron-microscopic study and three-dimensional examination of serial sections

Flbrolamellar carclnoma (FLC) Is a varlant of hepatocellular carcinoma characterlzed by dlstlnct pathologicel features. The presence of Intracellular lumlna resembling blle canalicull was previously reported in tumor cells of FLC on electron microscopy. Using light microscopy, we describe the presence of intracellular lumina In FLC, which was resected from a 15-year-old Japanese girl, as round structures lined with a brush-like border. These lumina occasionally contained blle. Light microscopic examination of 1 μm thick serial sections of Eponembedded tissue samples showed that the lumina were located in the intracellular space without any connection to the Intercellular space. However, we also detected a small number of lumlna that were lined by microville which were present between adjacent tumor cells. Results suggest that the presence of the Intracellular Iumlna in tumor cells probably represents a common histopathologic feature of FLC.     

血管肌纤维母细胞瘤16例临床病理分析

目的探讨血管肌纤维母细胞瘤（angiomyofibroblastoma,AMF）的临床病理、免疫组化特征、组织来源以及鉴别诊断。方法通过16例AMF的临床表现、病理形态和免疫组化研究,并结合文献复习,总结AMF的临床病理、免疫组化特征及鉴别诊断。结果16例AMF,大体境界清楚,无包膜,可见一层假纤维膜包绕;组织学上呈疏松水肿样,丰富薄壁海绵样血管,肿瘤细胞多样性,梭形及上皮样细胞多见,常围绕血管排列呈疏密交替分布特征。免疫组化结果：瘤细胞desmin及vimentin呈弥漫强阳性表达,actin、CD34、ER和PR染色稍弱、呈灶状分布,而S-100蛋白、NF和CK均阴性。结论AMF临床上多无明显症状;发病部位以女性外阴及盆腔最多见,但全身多处部位也可见;其生物学行为及组织来源尚无定论;术前很难确定诊断AMF,需与侵袭性血管黏液瘤、富于细胞性血管纤维瘤等相鉴别。     

Cytokeratin immunolocalization and lectin binding studies in oesophageal squamous dysplasia

Aggressive angiomyxoma is a distinctive soft tissue tumour associated with a high risk of local recurrence but lacks metastatic potential. This tumour occurs nearly exclusively in the soft tissues of the pelvis and perineum of adult women. The line of differentiation is not firmly established, but a fibroblastic/myofibroblastic origin has been proposed. We report 16 new cases of aggressive angiomyxoma of the pelvic soft tissue in women. In all cases bundles of cells, most often adjacent to vessels, with histological features of smooth muscle cells were identified. In 11 of 14 cases the myoid bundles were immunoreactive for desmin; they were also postive for smooth muscle actin in 10 of 11 cases. In 13 of 14 cases lesional stromal cells showed immunoreactivity for desmin. Three cases showed areas with histological features similar to those of angiomyofibroblastoma of the vulva, thus representing previously undescribed morphological overlap between these two entities. We conclude that aggressive angiomyxoma and angiomyofibroblastoma are related neoplasms in a spectrum of tumours showing myofibroblastic origin. Furthermore, the demonstration of immunoreactivity for desmin in aggressive angiomyxomas implies that this antibody is not helpful in discriminating between these two tumours, and the principal means of distinction remains histomorphological analysis.     

Vulvar angiomyxoma, aggressive angiomyxoma, and angiomyofibroblastoma: an immunohistochemical and ultrastructural study

To investigate the histogenetical unifying theory of a single, pluripotential primitive cell for vulvar angiomyxoma, aggresive angiomyxoma, and angiomyofibroblastoma, an optical, immunohistochemical and ultrastructural study of a superficial angiomyxoma, aggressive angiomyxoma, and angiomyofibroblastoma was performed. These three tumors showed immunohistochemical and ultrastructural overlapping features. The results of the study suggest that these three tumor entities probably arise on a common pluripotential primitive cell located around the vessels of connective tissue, which could show the capacity for modulating its penotype toward similar but distinct mature cell types.     

侵袭性血管黏液瘤7例临床病理分析

目的探讨侵袭性血管黏液瘤(aggressive anginomyxoma,AAM)的临床病理特征与鉴别诊断。方法收集7例AAM,并与2例血管肌纤维母细胞瘤(AMFb)、1例浅表性血管黏液瘤作对照观察。免疫组织化学(采用SP法)所用抗体为vimentin、desmin、SMA、MSA、CD34、ER/PR、S-100蛋白、CK和CD68。结果7例AAM患者均为女性,23~54岁,中位年龄43·5岁。病变部位位于外阴部3例,累及阴道1例,位于盆腔及髂窝部2例,会阴累及坐骨结节1例。肿瘤直径3·5~17cm,平均7·5cm。位于皮下或较深部,呈浸润性生长,切面均质灰白或灰黄褐色,黏液胶冻样或肉质样。镜下瘤细胞幼稚,呈星形、梭形,弥漫或结节样分布,基质黏液样变性并见胶原纤维及为数众多的大小厚薄不一的血管分布其中,厚壁血管常透明变性,其周围常有增生肌纤维束,切面呈“袖套状”,间质可见肥大细胞和红细胞外渗,1例可见多核巨细胞,肿瘤边缘浸润等特点。组织化学奥辛蓝染色阳性,免疫组化:7例AAM vimentin均阳性,5例SMA和desmin阳性,4例MSA阳性,3例CD34阳性,4例中有3例ER/PR阳性,而S-100蛋白、CK、CD68均阴性,多核巨细胞CD68阳性。5例有随访,术后1~2年有3例复发,2例未见复发和转移,健在。结论侵袭性血管黏液瘤较为少见,好发于成年女性盆腔及会阴的软组织,侵袭性和复发性是其重要的临床特征。病理诊断易误诊或漏诊。免疫组化desmin、SMA、MSA、CD34等联合检测对确定AAM病变有所帮助,但与AMFb、浅表性血管黏液瘤在鉴别诊断上意义不大。