论文部分内容阅读
目的探讨成人先天性肺囊性腺瘤样畸形的临床病理特征。方法分析2012年11月19日及2014年2月12日收治的2例成人先天性肺囊性腺瘤样畸形的临床资料、病理组织学特征,并复习相关文献。结果 2例患者均为男性,年龄分别为59岁和60岁,均以咳嗽、咳痰、咯血、发热等呼吸道症状入院。病变均累及一侧肺叶,呈囊性,大小分别为4.0 cm×3.0 cm×1.5 cm、5.0 cm×5.0 cm×3.0 cm。显微镜下见正常的肺泡被腺瘤样增生的细支气管构成的囊腔所代替,囊腔大小不等,囊内壁衬覆假复层纤毛柱状上皮,囊壁含平滑肌和弹力组织,未见软骨。其中1例患者部分囊内壁可见黏液细胞衬覆,灶性上皮细胞非典型增生。结论先天性肺囊性腺瘤样畸形是一种罕见的先天性肺发育异常,多见于新生儿和婴儿,成人少见。结合临床特点、影像学改变及病理组织学特征可以明确诊断。
Objective To investigate the clinicopathological features of congenital cystic adenomatoid malformation in adults. Methods Clinical data, histopathological features of 2 cases of adult congenital cystic adenoma of the lung were analyzed on November 19, 2012 and February 12, 2014, and the related literatures were reviewed. Results Both of the two patients were male, aged 59 and 60 years old, respectively, and were admitted to hospital with respiratory symptoms such as cough, sputum, hemoptysis and fever. Lesions were involved in the side of the lungs, cystic, size were 4.0 cm × 3.0 cm × 1.5 cm, 5.0 cm × 5.0 cm × 3.0 cm. Under the microscope, the normal alveolus was replaced by the cyst which is composed of the bronchioles of adenomatous hyperplasia. The sizes of the cysts were different. The pseudostratified ciliated columnar epithelium was covered by the inner wall of the sac. The cartilage contained smooth muscle and elastic tissue with no cartilage. One of the patients showed partial mucosal lining of mucous cells and atypical hyperplasia of focal epithelial cells. Conclusion Congenital cystic adenomatoid malformation is a rare congenital pulmonary dysplasia, more common in newborns and infants, rare in adults. Combined with clinical features, imaging changes and histopathological features can confirm the diagnosis.