肺微小脑膜上皮样结节的临床病理分析及讨论
Clinicopathologic Analysis and Discussion of Minute Pulmonary Meningothelial-Like Nodules
徐闵 1杨旭丹 2钱欢 3段国强 1张容1
作者信息
- 1. 苍溪县人民医院病理科,四川 广元 628400
- 2. 四川省医学科学院·四川省人民医院病理科,四川 成都 610072
- 3. 广元市第一人民医院病理科,四川 广元 628017
- 折叠
摘要
目的 探讨肺微小脑膜上皮样结节(MPMN)临床病理学特征.方法 收集 2019 年 4 月至 2022 年 9 月 47例病理诊断为MPMN的病例进行年龄、性别、部位、临床表现、影像学(CT)、伴随疾病、单病灶和多病灶、肿瘤大小等情况进行对比统计分析.临床病理特征方面通过组织学、免疫组化,同时与肺脑膜瘤的鉴别方面进行对比分析.结果 47 例患者年龄范围36～80 岁,平均59.7 岁.发生部位:左上9 例、左下14 例、右上8 例、右下14 例、右中2 例.临床表现为无症状32 例、咳嗽8 例、胸痛6 例、门诊1 例无病史,均无发热现象.伴随疾病:浸润性腺癌17 例;微小浸润性腺癌20 例;良性7 例;无伴随疾病3 例.影像学(CT):磨玻璃影44 例;实性2 例,无原始数据 1 例.吸烟史:其中 1 例男性有明确吸烟史,其余46 例烟史不详.病变:单发40 例,占85.1%;多发6 例,占12.8%;1 例无数据,占2.1%.MPMN是由中等大小的上皮样细胞围绕肺泡腔排列,呈小簇状、漩涡状填充式生长,常伴随肺间质小血管,这些细胞与正常的蛛网膜细胞和脑膜瘤细胞相似,形态学温和,细胞大小中等,呈短梭形或椭圆形,细胞质丰富、嗜酸性,核染色质细腻,核仁不明显,部分细胞可见核内包涵体,Ki-67 增殖指数均较低(<2%).结论 MPMN多发于肺下叶,常伴发肺腺癌(78.8%),PR阳性表达率较高(100%),对MPMN目前组织起源情况进行文献学习,明确该病变尚待进一步深入学习研究.
Abstract
Objective To study the clinical pathological features of minute pulmonary meningothelial-like nodules(MPMN).Methods In this study,47 cases of MPMN which were diagnosed by pathology from April 2019 to September 2022 were collected for comparative and statistical analysis of age,sex,location,clinical manifestations,imaging(CT),concomitant disease,single and muti-focus lesions,size of tumor and so on.Clinical pathological features of MPMN were analyzed via histology,immunohis-tochemistry,comparison with the identification method of pulmonary meningiomas at the same time.Results The average age was 59.7 of 47 patients who aged from 36 to 80.Location was as following:upper-left(9 cases),lower-left(14 cases),upper-right(8 ca-ses),lower-right(14 cases)and middle-right(2 cases).Clinical manifestationshad asymptomatic infection(32 cases),cough(8 ca-ses),chest pains(6 cases),no medical history(1 outpatient).All these 47 patients had no fever.Concomitant disease had invasive adenocarcinoma(17 cases),micro-invasive adenocarcinoma(20 cases),benign(7 cases),no concomitant disease(3 cases).Imaging(CT)had ground glass opacity(44 cases),solid nodules(2 cases),no original data(1 case).Smoking history was that one male had a definite smoking history while the other 46 were unknown.Lesions were single(40 cases accounting for 85.1%),multi-focus(6 ca-ses accounting for12.8%),one case with no data,accounting for2.1%.MPMN was composed of medium-sized epithelioid cells ar-ranged around the alveolus cavity,which grow in small clusters and swirls,often accompanied by small pulmonary interstitial blood vessels.These cells,with mild morphology,medium size,short spindle-shape or oval shape,were similar to normal arachnoid cells and meningiomas cells.They had abundant cytoplasm and were acidophilic with delicate nuclear chromatin and obscure nucleolus.Intra-nuclear inclusion body could be found in some cells,and Ki-67 proliferation index(<2%)was low.Conclusion MPMN is more common in inferior lobe of lung.Lung adenocarcinoma(78.8%)would be often associated with the disease,and PR positive expres-sion rate would be high(100%)in the actual situation.We could learn current origin of MPMN tissue by studying the literature.Fur-ther study and research are needed to identify this lesion.
关键词
肺/微小脑膜上皮样结节/肺原发性脑膜瘤/良性病变Key words
lung/minute pulmonary meningothelial-like nodules/primary pulmonary meningioma/benign lesion引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据