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目的:探讨印戒细胞样型恶性间皮瘤的临床病理诊断、鉴别诊断及其预后。方法:对1例印戒细胞样型恶性间皮瘤进行临床病理分析、免疫组化及组织化学观察,并复习相关文献。结果:印戒细胞样型恶性间皮瘤临床表现多样,发生在胸膜早期常无症状或仅表现运动后气促,最常见的症状是呼吸困难和胸痛,发生在心包则早期常出现心慌、气短等症状。病理组织学形态特征以印戒样细胞为主,弥漫分布,细胞大小不一,有异型性,可见少许腺样结构。免疫组织化学:肿瘤细胞对Calretinin、D2-40、CK5&6、EMA、Vimentin呈阳性表达,CEA、TTF1及Naspin A呈阴性。组织化学:CI染色均阳性,HCI染色阴性。结论:印戒细胞样型恶性间皮瘤是罕见的恶性间皮瘤的一种亚型,其诊断应从临床部位、组织形态、免疫组化及组织化学等多方面综合考虑。
Objective: To investigate the clinical pathological diagnosis, differential diagnosis and prognosis of signet-ring cell-type malignant mesothelioma. Methods: One case of signet-ring cell-type malignant mesothelioma was analyzed by clinicopathology, immunohistochemistry and histochemical observation, and related literature was reviewed. Results: Signet-ring cell-type malignant mesothelioma has various clinical manifestations. It often occurs in the early pleura and is usually asymptomatic or shows only shortness of breath after exercise. The most common symptoms are dyspnea and chest pain. Occurrence in the pericardium often occurs in palpitation and shortness of breath. Other symptoms. Histopathological morphological characteristics were mainly signin-like cells, diffusely distributed, and the cells were of different sizes and heteromorphism. A little adenoid structure was seen. Immunohistochemistry: Tumor cells positively expressed Calretinin, D2-40, CK5&6, EMA, Vimentin, and CEA, TTF1, and Naspin A were negative. Histochemistry: CI staining was positive and HCI staining was negative. Conclusion: Signet-ring cell-type malignant mesothelioma is a rare subtype of malignant mesothelioma. The diagnosis should be based on clinical sites, histomorphology, immunohistochemistry and histochemistry.