实用器官移植电子杂志 ›› 2015, Vol. 3 ›› Issue (3): 142-145.

• 论著 • 上一篇    下一篇

肝上皮样血管内皮瘤的诊断与治疗:附 1 例报告及文献复习

马明,崔玉军,蒋文涛
  

  • 出版日期:2015-05-20 发布日期:2021-06-28

Diagnosis and treatment of hepatic epithelioid hemangioendothelioma:one case report and literature review

  • Online:2015-05-20 Published:2021-06-28

摘要:

目的 探讨肝上皮样血管内皮瘤(hepatic epithelioid haemangioendothelioma,HEHE)的临床诊断及治疗特点。方法 报道天津市第一中心医院 1 例 HEHE 患者,标本经苏木素 - 伊红(HE)染色后光镜观察,同时采用 En Vision 免疫组化二步法检测 CD31、CD34、Vim、CK19、AE1/AE3 蛋白的表达情况,随访患者,结合其临床表现及病理形态并复习相关文献。结果 切除该例 HEHE 患者的肝左外叶和肝右后叶肿块,切面可见 5 cm×2 cm×2 cm,有灰白、灰红结节数数,边界不清,质稍硬。镜检穿刺组织、肿瘤细胞呈卵圆形或不规则形,排列成条索状,胞质丰富呈嗜酸性,部分区域可见片状坏死及钙化,肿瘤与周围肝组织的界限不清。免疫组化结果为肿瘤细胞 CD31、CD34、Vim 阳性,HMB45、S-100、Desmin、SMA 阴性。该患者随访 5 年,患者健在,但肝、肺多发转移灶。结论 HEHE 是一种少见的低度恶性肿瘤,易误诊, 了解该肿瘤的临床及病理特点有助于鉴别其他易混淆的肿瘤类型。

Abstract:

Objective To summarize and analyze the clinical characteristic of HEHE in ChinesepatientsMethods A patent with HEHE underwent liver transplant in Tianjin First Center Hospital,samplesstained by hematoxylin eosin(HE)the morphological characteristics of this cases of hepatic EH were observed.At the same time,detect the expressionof CD31,CD34 protein with En Vision two step immunohistochemical method. According to the clinical manifestations,pathological morphology and the review of the literature. Results The tumor occupied left lateral lobe and right posterior of the liver,Section 5 cm×2 cm×2 cm gray,gray red nodule count,the boundary is not clear,slightly hard matter. Microscopic examination of biopsy,tumor cells were oval or irregular in shape,arranged in cords,abundant cytoplasm is eosinophilic,necrosis and calcification can be seen insome areas,the boundaries of tumor and surrounding liver tissue is unclear. The results of immunohistochemistry fortumor cell CD31,CD34,HMB45,S-100,Vim are positive,Desmin negative,SMA. The patients were followed up for 5 years,alive,but liver,multiple metastases were foung in the liver ans lungs. Conclusion HEHE is a rare low-grade malignant tumor,which is easy misdiagnosed,understand the clinical and pathological characteristic of the tumors can help identify other tumor types confusing.