Adenomatoid tumor of the pleura
Adenomatoid tumor of the pleura
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DOI：
10.1111/j.1440-1827.2009.02407.x
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发表时间：
2009-08-01
影响因子：
2.2
通讯作者：
Kinoshita, Eriko
中科院分区：
文献类型：
--
作者：
Minato, Hiroshi;Nojima, Takayuki;Kinoshita, Eriko
本文报告一例胸膜腺瘤样瘤，并讨论其与良恶性胸膜病变的鉴别诊断。一位54岁食道癌女性在胸部手术时意外发现一个小的胸膜结节。患者无石棉暴露史，术后14个月无复发迹象。一个7 mm的局限性肿瘤具有腺瘤样瘤的特征。肿瘤由不规则形状的管状囊状间隙和纤维性气孔组成。间隙内衬扁平和偶尔立方上皮样细胞，细胞质空泡化，几个间隙含有淡蓝色粘液。在免疫组织化学上，肿瘤细胞对AE1/AE3、CAM 5.2、波形蛋白、细胞角蛋白5/6、D2 - 40、钙视网膜蛋白、血栓调节蛋白和WT-1呈阳性，但对CEA、Leu M1（CD 15）、甲状腺转录因子-1、上皮膜抗原、结蛋白、葡萄糖转运蛋白-1（GLUT-1）、CD 31和CD 34呈阴性。MIB-1（Ki-67）标记指数为1 - 2%，表明低增殖活性。胸膜腺瘤样瘤是罕见的，其发病机制尚未阐明。认识这些良性胸膜间皮瘤病变是很重要的，以避免误诊。免疫组化结果支持其起源于间皮组织。
A case of adenomatoid tumor of the pleura is reported, and its differential diagnosis from benign and malignant pleural lesions is discussed. A small pleural nodule was incidentally found during a thoracic operation in a 54-year-old woman with esophageal cancer. The patient had no history of exposure to asbestos, and was well with no sign of recurrence 14 months after the operation. A 7 mm, circumscribed tumor had characteristic features of adenomatoid tumor. The tumor was composed of an aggregation of irregularly shaped tubulocystic spaces with fibrous stoma. The spaces were lined by flattened and occasional cuboidal epithelioid cells with cytoplasmic vacuolization, and several spaces contained pale blue mucinous fluid. On immunohistochemistry the tumor cells were positive for AE1/AE3, CAM5.2, vimentin, cytokeratin 5/6, D2-40, calretinin, thrombomodulin, and WT-1, but negative for CEA, Leu M1 (CD15), thyroid transcription factor-1, epithelial membrane antigen, desmin, glucose transporter-1 (GLUT-1), CD31, and CD34. The MIB-1 (Ki-67) labeling index was 1-2%, indicating low proliferative activity. Adenomatoid tumor of the pleura is rare, and the pathogenesis has not been elucidated. Recognition of these benign mesothelial lesions in the pleura is important to avoid misdiagnosis. The immunohistochemistry in the present case supports its mesothelial origin.