A case of microscopic, multiple sclerosing pneumocytoma
A case of microscopic, multiple sclerosing pneumocytoma
复制标题
DOI：
10.1111/pin.12648
复制
发表时间：
2018-03-01
影响因子：
2.2
通讯作者：
Noguchi, Masayuki
中科院分区：
文献类型：
--
作者：
Kawai, Hitomi;Takayashiki, Norio;Noguchi, Masayuki
硬化性肺细胞瘤是一种罕见的肺部肿瘤，通常影响中年女性，并且大多是孤立的。尽管这种肿瘤被认为源自原始呼吸道上皮细胞，但前体细胞的特征仍不清楚。一名 19 岁女性因右肺多发结节就诊。对右中叶进行部分切除，发现七个硬化性肺细胞瘤，其中四个是显微镜下可见的。后者显示出简单的乳头状图案，其中三个仅由圆形细胞样细胞（单一群体）组成。有趣的是，这些圆形细胞样细胞对 p63 和 TTF-1 均呈阳性，但对 SP-A 完全呈阴性。另一方面，其他四个硬化性肺细胞瘤的肿瘤细胞显示出具有双重群体的乳头状模式，TTF-1呈弥漫性阳性，SP-A局灶性阳性（仅在表面细胞中），但p63呈阴性或非常局灶性阳性。据报道，p63阳性干细胞样细胞存在于远端气道中，并且具有分化为II型肺细胞的潜力。这些多个显微病变的免疫组织化学特征表明p63-TTF-1双阳性细胞是硬化性肺细胞瘤的候选前体细胞。
Sclerosing pneumocytoma is a rare tumor of the lung, commonly affecting middle-aged women, and is mostly isolated. Although this tumor is thought to be derived from primitive respiratory epithelial cells, the characteristics of the precursor cells are still unknown. A 19-year-old woman presented with multiple nodules in the right lung. Partial resection of the right middle lobe was performed, and seven sclerosing pneumocytomas, including four that were microscopic, were detected. The latter showed a simple papillary pattern, and three of them consisted of only round cell-like cells (single population). Interestingly, these round cell-like cells were positive for both p63 and TTF-1, but totally negative for SP-A. On the other hand, the tumor cells of the other four sclerosing pneumocytomas showing a papillary pattern with a dual population, were diffusely positive for TTF-1 and focally positive for SP-A (only in surface cells), but negative or very focally positive for p63. It has been reported that p63-positive stem cell-like cells are present in the distal airway and have potential to differentiate into type II pneumocytes. The immunohistochemical features of these multiple microscopic lesions suggest that the p63-TTF-1 double-positive cells are candidate precursor cells of sclerosing pneumocytoma.