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目的:探讨肝血管平滑肌脂肪瘤(HAML)的免疫组织化学特征及超微结构特点。方法:对5例HMAL进行免疫组化及超微结构观察,并结合文献分析。结果:5例HAML中免疫组化显示:瘤细胞呈HMB45(5/5)、SMA(5/5)、S-100(3/5)阳性、CD34、CKp、Hepatocyte、CD10、Inhibinα阴性。超微结构下瘤细胞形态多样,大小不一,短梭形或圆形或多形性,细胞核大小一致,多呈圆形或短梭形,常染色质丰富,异染色质呈质块状;部分细胞核切迹明显;核仁大小不一,胞浆内线粒体丰富,部分细胞浆内可见多少不等的密体;少部分细胞可见少量脂滴;多数胞浆内可见100～200nm左右的致密颗粒;细胞间可见基底膜样物质围绕细胞周围,仅个别细胞可见桥粒样连接。结论:HAML具有特殊的免疫组化特征及超微结构特点;HMB45和SMA的双阳性表达及超微结构下密体和致密颗粒的并存对HAML的诊断具有重要的意义。
Objective: To investigate the immunohistochemical features and ultrastructural features of hepatic angiomyolipoma (HAML). Methods: Immunohistochemical and ultrastructural observation of 5 cases of HMAL were performed and analyzed by literature. Results: Immunohistochemistry of HAML in 5 cases showed that the tumor cells were negative for HMB45 (5/5), SMA (5/5), S-100 (3/5), and CD34, CKp, CD10 and Inhibinα. Under the ultrastructure, the tumor cells are diverse in shape, size, short fusiform or round or pleomorphic, the nucleus size is the same, mostly round or short fusiform, the euchromatin is abundant, the heterochromatin is massive; Part of the nuclei notch obvious; nucleoli size, rich in mitochondria cytoplasm, some cytoplasm can be seen in the number of unequal dense body; a small number of cells showed a small amount of lipid droplets; most cytoplasm visible 100 ~ 200nm dense particles The basal membrane-like substances around the cells were observed around the cells, and only a few cells showed desmosome-like connections. CONCLUSION: HAML has special features of immunohistochemistry and ultrastructure. The double positive expression of HMB45 and SMA and the coexistence of dense body and dense granule under ultrastructure are of great significance for the diagnosis of HAML.