肺炎性假瘤的临床病理分析

目的：为提高对肺炎性假瘤的认识及诊治水平，探讨肺炎性假瘤的病理特片。方法：对26例手术切除并经病理证实的炎性假瘤，应用免疫组化LSAB法，进行了5种抗体（Vim、LCA、KP－1、AE1／AE3及VS38－C）的检测。将检测结果与常规病理和临床资料进行分析。结果：HE染色瘤体中淋巴细胞比例与LCA阳性率、组织细胞比例与瘤体间质中KP－1阳性率基本吻合（分别有1例出现轻微差异）。浆细胞数与VS38－C的阳性表达率间存在着明显的差异，除1例阳性表达外，所有浆细胞对VS38－C均无反应。Vim在2例瘤体间质中呈轻度阳性表达。AE1／AE3在瘤组织中呈现不均匀分布，阳性率平均为＋。结论：炎性假瘤与肺癌在影像学上难以鉴别；经检测炎性假瘤中的浆细胞可能多数来自淋巴细胞；假瘤癌变者应系瘤体中残存肺泡上皮和支气管上皮恶变；进一步确立了炎性假瘤应手术切除。

Clinical Pathological Analysis of Pulmonary Inflammatory

objective:To raise the efficacy of diagnosis and treatment of pulmonary inflammatory pseudotumor(PIP),and to study its nature and the histogenesis.Method:The specimens excised surgically from 26 patients were confirmed as PIP following pathological examination,and these specimens were farther examined by immunochemical methods in cluding KP-1,LCA,Vim,AE1/AE3 and VS38-C antibodies with labeled strept-avidin-biotin method (LSAB).The immunohistochemistry outcomens,routine pathological findings data.Results:The number of lymphocyte vs positive rate of LCA and the number of histocyte vs positive rate of KP-1 in pseudotumor were analyzed.The Contrast was very significant in number of plasmacyte vs positive rate of VS38-C,and positive expression was only in one case,vim was gently positive in 2 cases,and AE1/AE3 distribution in pseudotumor was not uniform.Conclusion:There was not significant difference between pulmonary inflammatory pseudotumor and lung cancer on radiological silhouette.Plasmacyte in pseudotumor came fromlymphocytic cel differentiation.The aleolar and bronchus epithelium remaining in pseudotumor could undergo malignant degeneration.It was suggested of that pulmonary inflammatory pseudotumor should undergo resection.