Pulmonary sclerosing hemangioma consistently expresses thyroid transcription factor-1 (TTF-1) - A new clue to its histogenesis
Pulmonary sclerosing hemangioma consistently expresses thyroid transcription factor-1 (TTF-1) - A new clue to its histogenesis
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DOI：
10.1097/00000478-200011000-00009
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发表时间：
2000-11-01
影响因子：
5.6
通讯作者：
Chan, JKC
中科院分区：
文献类型：
--
作者：
Chan, ACL;Chan, JKC
尽管许多研究者进行了广泛的研究，但肺硬化性血管瘤的组织发生仍然存在争议。针对甲状腺转录因子 1 (TTF-1)（在 II 型肺细胞和 Clara 细胞中表达）的抗体的出现促使我们重新解决这个问题。 16 个病例用包括 TTF-1 在内的一组抗体进行了免疫染色。患者主要是女性，年龄范围为 30 至 73 岁（平均 52 岁）。所有肿瘤都是孤立的。这名单身男性患者出现区域淋巴结转移，这种不寻常的现象在文献中只报道过一次。所有病例均表现出典型的组织学特征，且形态多样。在表面衬里细胞和浅多边形细胞中均观察到 TTF-1 表达。表面衬里细胞是上皮膜抗原(EMA)+细胞角蛋白+表面活性剂脱辅基蛋白A+，而多边形细胞是EMA+细胞角蛋白-表面活性剂脱辅基蛋白A-。神经内分泌标志物突触素和嗜铬粒蛋白均为阴性。淋巴结中的转移性沉积物仅包含多边形细胞，并表现出 EMA+ 细胞角蛋白-表面活性剂脱辅基蛋白 A-TTF-1+ 免疫表型。这些结果表明，肺硬化性血管瘤是一种来源于原始呼吸道上皮或不完全分化的II型肺细胞或Clara细胞的上皮肿瘤。
The histogenesis of pulmonary sclerosing hemangioma has remained controversial despite extensive studies by many investigators. The availability of an antibody to thyroid transcription factor-1 (TTF-1), which is expressed in type II pneumocytes and Clara cells, has prompted us to readdress this issue. Sixteen cases were immunostained with a panel of antibodies including TTF-1. The patients were predominantly women with an age range of 30 to 73 years (mean, 52 yrs). All tumors were solitary. The single male patient showed regional lymph node metastases, an unusual occurrence reported only once in the literature. All cases exhibited the classic histologic features, with variegated patterns. TTF-1 expression was observed in both the surface lining cells and the pale polygonal cells. The surface lining cells were epithelial membrane antigen (EMA)+ cytokeratin+ surfactant apoprotein A+, whereas the polygonal cells were EMA+ cytokeratin- surfactant apoprotein A-. The neuroendocrine markers synaptophysin and chromogranin were both negative. The metastatic deposits in the lymph nodes comprised only polygonal cells and exhibited an EMA+ cytokeratin- surfactant apoprotein A- TTF-1+ immunophenotype. These results suggest that pulmonary sclerosing hemangioma is an epithelial neoplasm derived from primitive respiratory epithelium or incompletely differentiated type II pneumocyte or Clara cell.