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目的探讨硬化性肺细胞瘤(PSH)的临床病理特点,以提高对PSH术中冷冻诊断的准确性。方法收集11例PSH的临床资料,回顾性分析这些病例冷冻切片与石蜡切片的组织学特点。结果 PSH多见于中年女性,一般无临床症状。大体肿瘤边界较清。镜下观察到乳头状、实性、硬化性和血管瘤样结构及2种细胞。本组11例均行术中冷冻检查,5例诊断为PSH,3例诊断为良性肿瘤,3例未排除肺癌,需待石蜡切片确诊。7例冷冻切片见>3种组织结构,4例仅见2种组织结构,以1种组织结构(如实性结构或乳头状结构)为主。结论 PSH虽较为少见,但有必要纳入肺结节性病变冷冻检查的鉴别诊断范畴,此时肿瘤由2种细胞构成,肿瘤结构的多样性以及肿瘤与周围组织的明显界限是鉴别PSH与肺恶性肿瘤的重要标志。
Objective To investigate the clinicopathological features of sclerosing pneumocytoma (PSH) to improve the accuracy of frozen diagnosis in PSH. Methods The clinical data of 11 cases of PSH were collected. The histological features of frozen sections and paraffin sections of these cases were retrospectively analyzed. Results PSH more common in middle-aged women, generally no clinical symptoms. The general tumor border more clear. Microscopically observed papillary, solid, sclerotic and hemangio-like structure and two kinds of cells. The group of 11 patients underwent intraoperative cryogenic examination, 5 cases diagnosed as PSH, 3 cases diagnosed as benign tumor, 3 cases did not rule out lung cancer, need to be confirmed by paraffin section. Seven frozen sections were found in> 3 kinds of tissues, 4 cases only in 2 kinds of tissues, and 1 kinds of tissues (such as solid structure or papillary structure) were the main ones. Conclusion Although PSH is relatively rare, it is necessary to include the differential diagnosis of pulmonary nodular lesions by cryopreservation. At this time, the tumor consists of two kinds of cells. The diversity of the tumor structure and the clear boundary between the tumor and the surrounding tissue are the identification of PSH and malignancy of the lung An important indicator of cancer.