摘要
目的探讨肺髓脂肪瘤的临床病理特点和鉴别诊断。方法患者因咳嗽、胸闷20天，左肺上叶占位入院。X线示边界清楚的密度不均的囊性包块。CT扫描左上肺门4cm×3．5cm大小类圆型囊状低密度影，边界呈囊状高密度，可见钙化，其中心密度较低，可能为液化坏死组织或脂肪组织。结果肿瘤类圆形，4．4cm×3．5cm大小，切面呈囊性，囊空直径2．5cm，内含黏液；囊壁厚2～2．5cm，最外层为蛋壳样质硬骨样组织，约厚0．5cm，囊壁内层主要为软组织，灰红间杂灰黄色。镜下见肿物软组织部分由成熟脂肪组织（约占60％）和骨髓造血组织混合组成，骨髓组织含有正常比例的三系造血细胞。囊壁质硬部分为薄层新生骨小梁和软骨。结论肺髓脂肪瘤少见，目前国内外仅有8例报告，本例呈囊性并有骨软骨化生更为罕见。诊断依赖病理组织学检查，需与错构瘤、髓外造血和骨髓增生性疾病等鉴别。
Objective To discuss the chnical and pathological characteristics and differential diagnosis of pulmonary myelolipoma. Methods We presented a case of cystic lung myelolipoma and reviewed the hteratures. A 45-year-old male patient with cough and pain in chest about two months was admitted to our hospital. Routine chest roentgenogram revealed a clear boundary cystic mass about 4.0-3.0 cm in diameter with uneven density in left lung. Computed tomography showed an oval cystic mass with low density in the anterior segment of the upper lobe. Marginal areas of higher density dues to hematopoietic tissue and, rarely, small foci of calcification were seen, suggnsting a malignant tumor with hquescence and necrosis. The tumor was removed. Results Lung benign lesion with bone marrow overgrowing was diagnosed by frozen section during the operation. The tumor was cystic and partly solid with bone and cartilage which seemed like an eggshell. Microscopically, it was composed of mature adipose and normal haematopeietic elements including mature and immature cells of all three cell lines. Conclusions lung myelolipema is an extremely rare benign tumor and only 8 cases were reported until now. This case is cystic and especially with the metaplasia of cartilage. The diagnosis can only be made by pathological examination and it should be differentiated from extramednllary hematopoietic tumors, myeloproliferative disease or lung hamartomas.
出处
《诊断病理学杂志》
CSCD
2009年第1期55-57,共3页
Chinese Journal of Diagnostic Pathology
