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目的 探讨肝单形性上皮样血管平滑肌脂肪瘤 (MEA)的临床病理学特征及诊断、鉴别诊断要点。方法 对 2例MEA进行临床病理学分析、免疫组织化学及电镜研究。结果 患者临床无症状。肿瘤由形态多样的上皮样细胞构成 ,胞质透亮或嗜酸 ,无脂肪细胞及异常血管 ;HMB4 5 (+) ,SMA和Vim部分 (+) ,Des少数 (+) ,S 10 0弱(+) ,CK和AFP(- ) ,CD34血管内皮细胞 (+)。电镜下瘤细胞胞质中微丝束上有高电子致密度的凝集物显示 ,可见黑色素样小体。结论 肝MEA是极为罕见的间叶性肿瘤 ,组织起源有争议 ,其诊断及鉴别诊断主要依靠组织病理学、免疫组织化学及电镜检查。
Objective To investigate the clinicopathological features, diagnosis and differential diagnosis of single-cell-like epithelial angiomyolipoma (MEA). Methods Two cases of MEA were analyzed by clinicopathological analysis, immunohistochemistry and electron microscopy. Results The patient was asymptomatic. The tumors consisted of various epithelial cells with translucent or eosinophilic cytoplasm, fat-free cells and abnormal blood vessels. HMB4 5 (+), SMA and Vim (+), Des + ), CK and AFP (-), CD34 vascular endothelial cells (+). Electron microscopy in the cytoplasm of the micro-bundles of high electron density of aggregates showed that melanin-like bodies can be seen. Conclusions Hepatic MEA is a very rare mesenchymal tumor. The origin of the tissue is controversial. The diagnosis and differential diagnosis mainly depend on histopathology, immunohistochemistry and electron microscopy.