第42卷第12期2022年12月Vol.42NO.12DEC.2022赣南医学院学报JOURNALOFGANNANMEDICALUNIVERSITY投稿网址:http://gnyxyxb.gmu.cn27例肺硬化性肺泡细胞瘤冰冻与石蜡病理诊断对比分析张伟,朱桂璐,方言,汪巧巧,焦南林(皖南医学院第一附属医院弋矶山医院病理科,安徽芜湖241000)摘要:目的:分析术中冰冻肺硬化性肺泡细胞瘤(pulmonarysclerosingpneumocytom,PSP)最常被误诊的原因及寻找对策。方法:回顾性分析27例PSP临床病理资料,复习冰冻和石蜡切片,结合免疫组化染色综合分析。结果:术中冰冻PSP的确诊率为70.4%(19/27),边界清楚及出现2种以上组织结构(尤其是乳头和硬化伴钙化的结构)容易被确诊;冰冻表现为单一血管瘤样或实体结构容易被误诊;免疫组化显示,PSP表面上皮细胞和间质细胞均表达EMA(18/18,100%)、TTF1(18/18,100%)和Vim(3/3,100%),且表面上皮细胞表达AE1/AE3(16/16,100%)、CK7(19/19,100%)和NapsinA(15/16,93.8%),间质细胞表达ER(7/10,70%)和PR(9/10,90%),间质细胞Ki-67指数≤3%。结论:冰冻中PSP有一定误诊率,存在5个陷阱:肿瘤边界不清、单一组织结构、血管瘤样腔内蛋白水肿液、间质细胞胞质透明或呈梭形、瘤周复杂的炎症背景。增加冰冻取材块数寻找其他几种结构及2类细胞有利于提高冰冻确诊率。关键词:肺硬化性肺泡细胞瘤;冰冻;石蜡;免疫组织化学中图分类号:R329.2+5文献标志码:A文章编号:1001-5779(2022)12-1237-06DOI:10.3969/j.issn.1001-5779.2022.12.003开放科学(资源服务)标识码(OSID):Comparisonbetweenfreezingsectionsandparaffinsectionsin27casesofpulmonarysclerosingpneumocytomZHANGWei,ZHUGui-lu,FANGYan,WANGQiao-qiao,JIAONan-lin(DepartmentofPathology,TheFirstaffiliatedHospitalofWannanMedicalCollege/YiJishanHospital,Wuhu,Anhui241000)Abstract:Objective:Toanalyzethereasonsformisdiagnosisofpulmonarysclerosingpneumocytoma(PSP)infrozensections,andfindthesolutiontotheproblem.Methods:Dataof27casesofPSPwerecollectedandreviewed.Alloriginalfrozensectionsandparaffinsectionswereobservedusinglightmicroscope.Immunohistochemicalstainingwerealsoperformed.Results:Therateofaccuratediagnosisusingfrozensectionswas70.4%(19/27),itiseasytodiagnosePSPwithwell-definednoduleandmorethantwokindsofhistologicalpa...