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目的：分析间皮瘤的病理形态特点及鉴别诊断。方法：通过对５０例间皮瘤大体分型与镜下形态的分析，总结二者关系及与其他肿瘤的区别，同时探讨免疫组化及电镜在其中的应用。结果：胸膜间皮瘤４１例，腹膜间皮瘤８例，睾丸鞘膜间皮瘤１例。局限纤维型均为良性。恶性间皮瘤中肉瘤型主要表现为局限性，上皮型及混合型主要表现为弥漫性（Ｐ＜０．０１），纤维生成型仅３例均表现为弥漫性。间皮瘤形态较复杂，与胸膜转移癌、肺癌累及胸膜等不易鉴别。免疫组化的应用及电镜对其鉴别诊断的帮助较大，其中ＣＫ，ＥＭＡ，Ｂｅｒ－ＥＰ４，Ｖｉｍｅｎｔｉｎ及ＣＥＡ一组抗体应用较广泛。结论：尽管间皮瘤病理形态多样，但仔细分析其特点，结合临床及免疫组化、电镜，仍可取得较为准确的诊断。
Objective: To analyze the pathological features and differential diagnosis of mesothelioma. Methods: Through the analysis of 50 cases of mesothelioma gross classification and microscopic morphology, the relationship between them and other tumors was summarized, and the application of immunohistochemistry and electron microscopy was discussed. Results: There were 41 cases of pleural mesothelioma, 8 cases of peritoneal mesothelioma, and 1 case of testicular sheath mesothelioma. The confined fiber types are all benign. The sarcoma types in malignant mesothelioma are mainly localized. The epithelial type and mixed type are mainly diffuse (P<0.01), and only 3 cases of fibrogenesis type are diffuse. The morphology of mesothelioma is more complex, and it is not easy to differentiate with pleural metastasis cancer, lung cancer involving the pleura. The application of immunohistochemistry and the aid of electron microscopy in the differential diagnosis of CK, EMA, Ber-EP4, Vimentin and CEA are more widely used. Conclusion: Although the pathomorphology of mesothelioma is diverse, careful analysis of its characteristics, combined with clinical and immunohistochemical, electron microscopy, can still obtain more accurate diagnosis.