Clinical and histopathological features of pulmonary sclerosing pneumocytoma with dense spindle stromal cells and lymph node metastasis
Clinical and histopathological features of pulmonary sclerosing pneumocytoma with dense spindle stromal cells and lymph node metastasis
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DOI：
10.1111/his.14159
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发表时间：
2020-10-06
期刊：
影响因子：
6.4
通讯作者：
Teng, Xiaodong
中科院分区：
文献类型：
--
作者：
Gao, Qiqi;Zhou, Jie;Teng, Xiaodong
目的探讨肺硬化性肺细胞瘤（PSP）伴梭形细胞及淋巴结PSP细胞阳性的临床病理特点。方法与结果本文报告了2007年至2019年在我院诊断的239例PSP患者中，5例伴有致密梭形间质细胞的PSP患者（其中1例伴有淋巴结转移）的临床、组织学和免疫组织化学特征，2例伴有淋巴结阳性。并对有关PSP的文献进行了详细的综述。女性6例，男性1例（淋巴结阳性）；他们的平均年龄为53岁。胸部影像学显示6例患者实体瘤边界清晰，质地均匀，但1例患者为分叶状肿瘤，密度不均匀。所有肿瘤均为单灶性，平均大小为31毫米。5例肿瘤主要由弥漫性梭形细胞组成，而非多边形细胞。免疫组化染色显示梭形细胞中有甲状腺转录因子-1、波形蛋白、上皮膜抗原（弱）和雌激素受体（部分）表达。平均随访31个月。有充分资料的234例PSP中有2例淋巴结阳性（转移率：0.8%），5例伴有梭形细胞的PSP中有1例出现淋巴结转移（转移率：20%）。此外，发现基质细胞在转移部位占主导地位。结论PSP间质细胞中存在梭形细胞，但并非全部为圆形细胞。伴有梭形细胞的PSP患者或男性患者可能比其他人更容易发生转移。
Aims To determine the clinicopathological features of pulmonary sclerosing pneumocytoma (PSP) with spindle cells and in cases with positive detection of PSP cells in the lymph nodes. Methods and results This article report the clinical, histological and immunohistochemical features of PSP with dense spindle stromal cells in five patients (including one case with lymph node metastasis) and PSP accompanied by positive nodes in two patients out of 239 cases diagnosed at our institution between 2007 and 2019. The literature on PSP was also reviewed in detail. Six patients were female, and one (with a positive node) was male; their average age was 53 years. Thoracic imaging revealed solid tumours with clear borders and a uniform texture in six patients, but one patient had a lobulated tumour with uneven densities. All tumours were unifocal, and they had an average size of 31 mm. Tumours from five cases were mainly composed of solid regions of diffuse spindle cells rather than polygonal cells. Immunohistochemical staining demonstrated that thyroid transcription factor-1, vimentin, epithelial membrane antigen (weak) and oestrogen receptor (partial) were expressed in spindle cells. The average follow-up time was 31 months. Two of the 234 PSP cases for which adequate data were available had positive nodes (metastasis rate: 0.8%), and one of the five patients with PSP with spindle cells showed lymph node metastasis (metastasis rate: 20%). In addition, stromal cells were found to be predominant at metastatic sites. Conclusions Spindle cells are present among the stromal cells of PSP, and not all of them are round cells. PSP patients with spindle cells or male patients may be more prone to metastasis than others.