肾上皮样血管平滑肌脂肪瘤肺转移1例报告并文献复习

目的：探讨肾上皮样血管平滑肌脂肪瘤病理特点及生物学行为。方法：对1例低热患者行肺肿块穿刺活检，然后行HE染色和免疫组织化学染色。复习肾肿瘤病理切片并进行文献复习。结果：穿刺活检病理分析：密集分布的上皮样细胞，细胞体积大，呈圆形、多边形；异型明显；无血管平滑肌脂肪瘤结构；免疫组织化学：人黑色素瘤蛋白阳性，平滑肌肌动蛋白阳性，上皮膜抗原阴性。病理诊断：左肺上皮样血管平滑肌脂肪瘤；考虑来源于肾。结论：上皮样血管平滑肌脂肪瘤是一种有恶性潜能的间叶性肿瘤，可以发生远处转移。

A case report and literature review on lung metastasis from renal epithelioid angiomyolipoma

Objective： To explore the pathological and biological behavior of renal epithelioid angiomyolipoma. Methods： Lung biopsy was performed in a woman suffered from low fever and the tissue was examined by HE staining and immunohistochemical staining. We also reviewed the renal tumor pathological section and the relevant literature. Results： The tumor was characterized by diffused epithelioid cells, which were large, rounded and polygonal with obviously abnormal shape and without the structure of angiomyolipoma. Immunohistochemical staining showed the tumor cells were positive for human melanoma black 45 （HMB45） and smooth muscle actin （SMA） while negative for epithelial membrane antigen （EMA）. The pathological diagnosis was left lung epithelioid angiomyolipoma diffused from kidney. Conclusion： Epithelioid angiomyolipoma has malignant potency of mesenchymoma with a tendency of distance metastases.