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目的探讨异位错构瘤性胸腺瘤(EHT)的临床病理特征、免疫组化和影像学特点。方法行免疫组化LSAB法检测相关抗体,并结合其影像学表现分析l例EHT的临床病理特征、免疫表型和影像学特点,并进行文献复习。结果胸部CT示肿物位于胸骨柄上缘左颈根部大小3 cm×2 cm的类圆形肿块,边界清楚光整,内部密度均匀,略低于肌肉密度。肉眼观呈圆球形,包膜完整,最大直径3 cm;切面呈灰白色,质地较韧。镜下示肿瘤主要由梭形细胞组成,混合有不同比例的上皮细胞和成熟的脂肪细胞。免疫组化:上皮细胞p63、CK5/6、EMA、CK7和CD99(+);梭形细胞p63、CK5/6、CD99、CD10和CD34(+),部分SMA和CD117(+);二者S-100和ER(-);Ki-67阳性指数5%。结论 EHT是一种少见的良性肿瘤,好发于中青年男性锁骨上和胸锁关节附近,有独特的发病部位和形态学表现。
Objective To investigate the clinicopathological characteristics, immunohistochemistry and imaging features of ectopic hamartoma. Methods Immunohistochemical LSAB method was used to detect related antibodies, and combined with its imaging findings analysis of 1 case of EHT clinical and pathological features, immunophenotype and imaging features, and literature review. Results Chest CT showed tumor located in the upper edge of the sternum left trocar size of 3 cm × 2 cm class circular tumor, the border clear and smooth, the internal density, slightly lower than the muscle density. The naked eye was spherical, complete capsule, the maximum diameter of 3 cm; section was gray, texture and tough. Microscopically, tumors are mainly composed of spindle cells mixed with different proportions of epithelial cells and mature adipocytes. Immunohistochemistry: p63, CK5 / 6, EMA, CK7 and CD99 (+) in epithelial cells; p63, CK5 / 6, CD99, CD10 and CD34 (+), some SMA and CD117 -100 and ER (-); Ki-67 positive index of 5%. Conclusion EHT is a rare benign tumor. It occurs in the middle of young and middle-aged men on the supraclavicular and sternoclavicular joint. It has a unique disease site and morphological manifestations.