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目的探讨肝血管平滑肌脂肪瘤(HAML)的临床及病理形态分析。方法 2009年10月至2011年10月期间,我院诊治的10例肝血管平滑肌脂肪瘤患者,给予常规处理,进行HE染色、特殊染色、免疫组织化学染色,然后进行光学显微镜检查,对其病例进行回顾性分析。结果 10例肝血管平滑肌脂肪瘤患者中,9例患者出现嗳气、腹胀等临床症状,1例患者没有明显的临床症状,所有患者肝功能均正常,B超、CT检查显示肝内存在占位性病变。肿瘤的构成成分以平滑肌细胞为主,形态表现为多形性。细胞核可出现轻度或者中度异形,细胞核浆比例基本正常,没有明显核分裂。经过PAS及淀粉酶消化后,进行PAS染色,2例患者的瘤细胞浆内发现抗淀粉酶消化的PAS阳性物质。结论对于肝血管平滑肌脂肪瘤患者,平滑肌HMB45表达,可以作为诊断依据,同时结合actin,desmin和vimentin的表达,以及电镜组织形态检查,具有较大的临床意义。
Objective To investigate the clinical and pathological features of hepatic angiomyolipoma (HAML). Methods From October 2009 to October 2011, 10 patients with hepatic angiomyolipoma diagnosed and treated in our hospital were routinely treated for HE staining, special staining, immunohistochemical staining, and then light microscopy. Retrospective analysis. Results Among the 10 patients with hepatic angiomyolipoma, 9 patients developed clinical symptoms such as belching and bloating, 1 patient had no obvious clinical symptoms, all patients had normal liver function, B-ultrasound and CT examination showed the presence of hepatic lesions Lesions. The main components of the tumor are smooth muscle cells, and the morphology is pleomorphic. The nucleus may appear mild or moderately shaped, the proportion of nuclear cytoplasm is basically normal, no obvious nuclear fission. After PAS and amylase digestion, PAS staining was performed, and anti-amylase-digested PAS-positive substances were found in the tumor cytoplasm of 2 patients. Conclusion In patients with hepatic angiomyolipoma, the expression of HMB45 in smooth muscle can be used as a basis for diagnosis, combining with the expression of actin, desmin and vimentin, as well as the histological examination by electron microscopy, which has great clinical significance.