A clinicopathologic study of 100 cases of pulmonary sclerosing hemangioma with immunohistochemical studies - TTF-1 is expressed in both round and surface cells, suggesting an origin from primitive respiratory epithelium
A clinicopathologic study of 100 cases of pulmonary sclerosing hemangioma with immunohistochemical studies - TTF-1 is expressed in both round and surface cells, suggesting an origin from primitive respiratory epithelium
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DOI：
10.1097/00000478-200007000-00002
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发表时间：
2000-07-01
影响因子：
5.6
通讯作者：
Travis, WD
中科院分区：
文献类型：
--
作者：
Devouassoux-Shisheboran, M;Hayashi, T;Travis, WD
肺硬化性血管瘤（SH）是一种组织发生不确定的肺部肿瘤，由两种主要细胞类型组成：表面细胞和圆形细胞。作者研究了 100 例肺部 SH 病例，这些病例表现为周围（95%）、孤立（96%）直径小于 3 厘米（74%）的肿块，无症状患者大多为女性（83%），平均年龄为 46.2 岁。对 47 例病例进行了多种上皮、间皮、肺细胞、神经内分泌和间质标记物的免疫组织化学分析，以研究该肿瘤的组织发生。 90%以上的病例表面和圆形细胞均被上皮膜抗原（EMA）和甲状腺转录因子-1（TTF-1）染色；然而，仅在 31% 和 17% 的病例中，圆形细胞的全细胞角蛋白均呈阴性，而细胞角蛋白-7 和 CAM5.2 呈阳性。表面活性蛋白 A 和 B 以及 Clara 细胞抗原在不同数量的表面细胞中呈阳性，但在圆形细胞中呈阴性。在 3 例病例中，检测到神经内分泌细胞为孤立的分散细胞或 SH 中心内的肿瘤（嗜铬粒蛋白、Leu-7、突触素阳性）。在 SH 圆形细胞中缺乏表面活性蛋白 A 和 B 以及 Clara 细胞抗原的情况下 TTF-1 的表达表明它们源自原始呼吸道上皮。肺泡肺泡细胞和神经内分泌细胞图要么代表原始呼吸道上皮成分的表型分化，要么它们可能对应于非肿瘤性截留或增生成分。 SH 中两种细胞类型的 TTF-1 和 EMA 同时呈阳性，而圆形细胞的全细胞角蛋白和神经内分泌标记物呈阴性，不仅为组织发生而且为这种肺肿瘤的诊断提供了有用的线索。
Pulmonary sclerosing hemangioma (SH) is a lung neoplasm of uncertain histogenesis that is composed of two major cell types: surface and round cells. The authors studied 100 cases of pulmonary SH that presented as a peripheral (95%), solitary (96%) mass of less than 3 cm in diameter (74%) in asymptomatic patients who were mostly women (83%) with a mean age of 46.2 years. Immunohistochemistry of multiple epithelial, mesothelial, pneumocyte, neuroendocrine, and mesenchymal markers was performed on 47 cases to investigate the histogenesis of this neoplasm. Both surface and round cells stained with epithelial membrane antigen (EMA) and thyroid transcription factor-1 (TTF-1) in more than 90% of cases; however, the round cells were uniformly negative for pancytokeratin and positive for cytokeratin-7 and CAM5.2 in only 31% and 17% of cases, respectively. Surfactant proteins A and B as well as Clara cell antigen were positive in varying numbers of surface cells but they were negative in the round cells. Neuroendocrine cells either as isolated scattered cells or as a tumorlet within the center of SH were detected (chromogranin, Leu-7, synaptophysin positive) in three cases. The expression of TTF-1 in the absence of surfactant proteins A and B and Clara cell antigens in the round cells of SH suggests that they are derived from primitive respiratory epithelium. The alveolar pneumocytes and neuroendocrine cells map either represent phenotypic differentiation of a primitive respiratory epithelial component or they may correspond to non-neoplastic entrapped or hyperplastic elements. The concomitant positivity of both cell types in SH for TTF-1 and EMA, and the negativity of round cells for pancytokeratin and neuroendocrine markers, provide useful clues not only for histogenesis but also for the diagnosis of this lung neoplasm.