论文部分内容阅读
目的研究胎儿肺型肺腺癌（ＦＬＡＣ）的病理学特征。方法结合文献，对４例ＦＬＡＣ病理资料和２个妊娠３个月胚胎肺，应用光镜、组织化学、免疫组织化学以及电镜超微结构进行观察对比研究。结果４例ＦＬＡＣ具有复杂分枝管状或乳头状腺体，腺上皮柱状或高柱状，胞浆透明富含糖原，类似于胚胎肺的气道结构；腺体间为良性纤维增生的间质；其中例１腺体较规则，膝上皮核小、圆或卵圆、分裂相少，见光亮核上皮细胞呈桑椹状凸入或占据腺腔，胞核Ｂｉｏｔｉｎ阳性，电镜下见其染色体由多量微丝组成，少数癌细胞浆内见神经内分泌型颗粒；另３例腺体不规则、腺上皮核异型明显、易见分裂相，无桑椹状结构，癌组织坏死常见；ＮＳＥ和ＣｇＡ染色仅例１、２灶性癌细胞阳性；ｐ５３和ＰＣＮＡ阳性表达率后者高于前者，ＡＦＰ染色例４灶性癌细胞阳性表达。结论ＦＬＡＣ腺体成分的病理学特点与妊娠３个月胚胎肺的气道结构相似；其中例１临床病理符合低恶ＦＬＡＣ或称肺内胚瘤，并具有向神经内分泌分化的特征；另３例为高恶ＦＬＡＣ。ＦＬＡＣ属于单向型肺母细胞瘤。
Objective To study the pathological features of fetal lung adenocarcinoma (FLAC). Methods Combined with the literature, 4 cases of FLAC pathological data and 2 embryos at 3 months of pregnancy were observed and compared using light microscopy, histochemistry, immunohistochemistry and electron microscopy ultrastructure. Results Four cases of FLAC had complex branching tubular or papillary glands, glandular epithelial columnar or tall columnar, and the cytoplasm was transparent and rich in glycogen, similar to the airway structure of the embryonic lung; the interstitial spaces were benign fibrosis. In Example 1, the glands were more regular. The epithelium of the knee was small, round or oval, and the division was small. The bright nucleus epithelial cells showed mulberry-like projections or occupation of glandular cavities. The nucleus Biotin was positive. Under the electron microscope, the chromosomes were seen in a large number of micro Silk composition, a small number of cancer cells see neuroendocrine particles; the other three cases of irregular glands, glandular epithelial nuclei obvious, easy to see the fissile phase, no mulberry-like structure, cancerous tissue necrosis common; NSE and CgA staining only Example 1 The positive rate of two-focal cancer cells was higher than that of the former. The positive rate of p53 and PCNA expression was higher than that of the former. Four cases of AFP stained positive tumor cells. Conclusion The pathological features of FLAC gland components are similar to those of embryonic lungs at 3 months of pregnancy. The clinical pathology of case 1 is consistent with hypoxic FLAC or pulmonary endoderm neoplasia and has a characteristic of neuroendocrine differentiation; the other 3 cases. For the high evil FLAC. FLAC is a one-way type of blastoma.