乳腺腺泡型横纹肌肉瘤1例及文献复习

目的：探讨乳腺腺泡型横纹肌肉瘤的病理诊断及鉴别诊断。方法：对1例乳腺腺泡型横纹肌肉瘤进行HE切片、免疫组化染色等观察并复习文献进行讨论。结果：镜检肿瘤细胞排列杂乱，可见部分呈腺泡及假腺管状，细胞呈短梭及圆形，胞浆丰富红染，核大偏位。肿瘤细胞特异性表达MyoD1。结论：乳腺腺泡型横纹肌肉瘤是非常罕见的恶性肿瘤，其肿瘤结构、细胞形态都有一定的特征，确诊需免疫组化染色的帮助，应与小细胞类型以及乳腺间叶组织可能发生的其他肉瘤相鉴别，同时横纹肌肉瘤的亚型区分对治疗也很重要。     

儿童横纹肌肉瘤临床病理及免疫组化观察

 本文报道儿童横纹肌肉瘤61例,男28例,女33例,平均年龄5.4岁,组织类型主要为幼稚横纹肌母细胞组成的胚胎型41例,(含葡萄状肉瘤),腺泡型18例,成熟型多形性仅2例。本文着重讨论了儿童与成人横纹肌肉瘤在发病年龄、部位、组织类型上有显著不同,并就其诊断及鉴别诊断提出了注意点。通过免疫酶标观察,认为肌红蛋白对诊断横纹肌肉瘤是一项重要参考指标。     

成人多部位胚胎性横纹肌肉瘤1例分析报告

目的探讨胚胎性横纹肌肉瘤的临床特征、诊断及鉴别诊断,提高对胚胎性横纹肌肉瘤的临床病理认识。方法结合参考文献对1例成人全身多部位ERMS进行病例分析。结果患者鼻咽、颈淋巴结、乳腺及眼眶多发性病变,双侧乳腺及眼眶病变为小圆形细胞肿瘤,结合免疫组化诊断为ERMS。结论成人ERMS罕见,可累及头颈部、乳腺、眼眶等多部位,及时活检和免疫组化多可明确诊断。     

动物横纹肌肉瘤细胞学组织学和超微结构的观察

对6例动物多形性横纹肌肉瘤进行了细胞学、组织学和超微结构观察。结果表明,横纹并不是光镜诊断横纹肌肉瘤必要的形态表现;电镜诊断该瘤的最低标准,应该是在胞浆中见到肌节样结构中的一个以上成份:粗丝和细丝,或完整的肌节。此外.对细针吸取细胞学在诊断多形性横纹肌肉瘤上的应用价值进行了讨论。     

梭形细胞横纹肌肉瘤5例临床病理分析

横纹肌肉瘤（RMS）是最常见的软组织恶性肿瘤之一，从形态学上分为多形性、胚胎性、腺泡状横纹肌肉瘤。梭形细胞横纹肌肉瘤较为少见，是胚胎性横纹肌肉瘤的一个亚型，以往文献对其也有不同描述，本文依据收集的5例梭形细胞横纹肌肉瘤进行病理分析。     

小肠组织细胞肉瘤1例报道并文献复习

目的：报道小肠组织细胞肉瘤1例并探讨其临床病理特点、诊断和鉴别诊断。方法：分析1例小肠组织细胞肉瘤光镜、免疫组化结果，并结合文献讨论。结果：镜下肿瘤细胞弥漫分布，细胞为单形或多形性，胞浆丰富，嗜伊红性。瘤细胞体积大，圆或卵圆，部分梭形。核圆或卵圆、可多核型，泡状核，轻到中度异型，核仁明显。免疫表型：肿瘤细胞LCA、CD45RO胞浆阳性，CD68、CD163、S-100、CD117、LYS、HLA—DP、-ATT阳性，SMA、CD1a灶状阳性，ACT、NSE、CD21、CD35、DES、CD23、HIA—DR阴性，Ki-67增殖指数为44％。结论：组织细胞肉瘤是一种少见的淋巴组织恶性肿瘤，诊断和鉴别诊断主要依赖其病理形态学特点并结合免疫表型。     

肺癌肉瘤与多形性癌临床病理分析

目的　探讨肺癌肉瘤与多形性癌的临床及病理特点。方法　对诊断为肺癌肉瘤和多形性癌 2 7例作回顾性分析 ,并用 S- P法作了 CK、EMA、Vim等免疫组化标记。结果　诊断肺癌肉瘤 7例 ,其中肉瘤部分为骨肉瘤 4例 ,软骨肉瘤 1例 ,横纹肌肉瘤 2例 ,肺多形性癌 2 0例。结论　肺癌肉瘤和多形性癌多发生在老年男性患者 ,可能与吸烟有关。两者肿块体积较大 ,有较强的侵袭性 ,预后较差。在发病年龄、肿块大小、病程等方面 ,两者无显著性差异(P>0 .0 5 )。     

左腹股沟淋巴结内指突状树突细胞肉瘤1例报告并文献复习

目的: 探讨淋巴结内指突状树突细胞肉瘤的临床病理特征、诊断要点及鉴别诊断.方法: 对1例腹股沟淋巴结内指突状树突细胞肉瘤进行组织病理学和免疫组化染色观察并随访,结合文献进行讨论.结果: 镜下显示淋巴结结构破坏,细胞呈梭形、圆形、椭圆形,肿瘤细胞弥漫分布,异性型明显,可见核分裂象,经化疗后肿瘤内可见片状凝固性坏死.免疫表型:瘤细胞表达Vimentin、CD68和S-100蛋白.结论: 淋巴结内指突状树突状细胞肉瘤是一种罕见的免疫辅助细胞恶性肿瘤.其诊断依靠组织病理学和免疫组化染色,必要时电镜辅助诊断.应与滤泡树突细胞肉瘤、朗格汉斯细胞组织细胞增生症、恶性纤维组织细胞肉瘤、恶性黑色素瘤、间,变性梭形细胞癌及其他肉瘤鉴别.治疗以手术切除为主,辅以化疗和(或)放疗,预后差.     

卵巢原发性多形性脂肪肉瘤病理分析及文献复习

目的：探讨多形性脂肪肉瘤（pleomorphic liposarcoma,PLS）的临床病理学特征.方法：对1例卵巢PLS进行大体、组织病理学和免疫组化染色观察,并复习相关文献.结果：肿瘤发生于一28岁女性患者卵巢.临床主诉为腹部肿块.镜下见肿瘤由多形性的梭形细胞及小圆形细胞组成,混有少量多核巨细胞.免疫组化：肿瘤细胞Vimentin、S-100阳性,desmin、SMA、myoglobin、EMA、AE1/AE3和HMB45均阴性.结论：卵巢PLS是一罕见的高度恶性软组织肿瘤,结合临床病理学特征及免疫组化,可作出正确诊断.     

髓系肉瘤五例并文献复习

 目的　研究髓系肉瘤（MS）的临床病理特征、诊断及鉴别诊断方法。方法　分析5例MS的临床表现、组织学、免疫表型及随访资料,并复习相关文献。结果　患者发病年龄31 ～55岁,平均年龄41.8岁,男3例,女2例。组织学表现为相对一致的未成熟的髓系细胞弥漫分布,细胞圆形或类圆形,胞质少,弱嗜碱性,核圆形,可见小核仁。肿瘤细胞MPO、lysozyme、CD43、CD34及CD38阳性。结论　MS临床罕见,极易误诊为其他小圆细胞肿瘤,免疫组织化学、骨髓及外周血检查对确诊MS 有重要价值。     

Pleomorphic carcinoma of the pancreas--report of 3 cases

The incidence of pleomorphic carcinoma of the pancreas is low. In 34 cases of non-endocrinic cancer of the pancreas detected pathologically by operation and autopsy in our hospital from 1961 to 1984, 3 were pleomorphic carcinoma, comprising 8.8%. In histology, the tumor was clearly characterized by the bizarre uninuclear and multinuclear giant cells with abundant eosinophilic cytoplasm and malignant spindle cells. In these 3 cases, the tumor was originated from the acinic epithelium in 2 and from the ductal epithelium in 1. This tumor should be differentiated from pleomorphic rhabdomyosarcoma, liposarcoma, fibrosarcoma and lymphosarcoma, etc.     

膀胱炎性肌纤维母细胞瘤的临床病理分析

探讨膀胱炎性肌纤维母细胞瘤的临床、病理和诊治方法及预后。方法:对2例膀胱炎性肌纤维母细胞瘤患者的临床资料、病理形态学和免疫组织化学染色进行观察;对2例患者进行随访观察。结果:病例1行膀胱部分切除术,病例2行全膀胱切除+盆腔淋巴结清扫术。组织学表现均为增生的梭形或长梭形肿瘤细胞囊状分布,间质小血管增生,伴淋巴细胞、嗜酸性粒细胞及浆细胞浸润。免疫组织化学染色结果:病例1为SMA（+）,Vimentin（+）,ALK（+）。病例2为SMA（+）,CD68（+）,Vimentin（+）,Cg A（+）,ALK（-）。2例病例均不表达CK7、S-100、MyoD1、CK19、α-actin、EMA。2例患者均未见复发。结论:膀胱炎性肌纤维母细胞瘤是一种少见肿瘤,确诊主要依据组织病理学检查及免疫组织化学染色,应与横纹肌肉瘤、梭形细胞癌等鉴别,治疗以膀胱部分切除或经尿道切除为主。      

横纹肌肉瘤与胚胎横纹肌超结构对比研究

Twelve cases of rhabdomyosarcoma identified by electron microscopy were studied. Of them, 6 were diagnosed originally as rhabdomyosarcoma and 6 as other tumors by light microscopy. Five types of tumor cells, primitive mesenchymal cells, undifferentiated myoblasts, poorly differentiated myoblasts, well-differentiated myoblasts and leptomeric fibril myoblasts were observed under electron microscope. Striated muscle tissue from 5 cases of 5-8 week old human embryo was used as control. There was a correlation in differentiation between rhabdomyosarcoma and embryonal striated muscle. Based on their fine features, the diagnosis of rhabdomyosarcoma is discussed.     

Characteristic of Uterine Rhabdomyosarcoma by Algorithm of Potential Biomarkers for Uterine Mesenchymal Tumor

Background/Aim: Patients with uterine sarcoma comprise 2–5% of all patients with uterine malignancies; however, the morbidity of uterine sarcoma is low compared with that of other gynecological cancers. For many cases, malignant uterine tumors are diagnosed during follow-up of benign uterine leiomyoma. Of the uterine sarcomas, rhabdomyosarcoma is considered a mixed tumor containing components of epithelial cells and mesenchymal cells. Therefore, the onset of primary uterine rhabdomyosarcoma during follow-up of uterine leiomyoma is extremely rare. Rhabdomyosarcoma is a relatively common malignant tumor in children, but rhabdomyosarcoma in adults is extremely rare, accounting for approximately 3% of all patients with soft tissue sarcoma. Rhabdomyosarcoma in children is highly sensitive to chemotherapy and radiation therapy; however, the response to chemotherapy and radiation therapy in adult rhabdomyosarcoma is low and survival in adult rhabdomyosarcoma with metastatic lesions to other organs is approximately 14 months. We experienced a case of pleomorphic rhabdomyosarcoma during the follow-up of a uterine leiomyoma. Materials and Methods: We examined the oncological properties of uterine rhabdomyosarcoma in adults using molecular pathological techniques on tissue excised from patients with uterine leiomyoma. Result: A differential diagnosis was made for this case by molecular pathology, which included candidate biomarkers for uterine smooth muscle tumors. The oncological nature of uterine rhabdomyosarcoma was found to be similar to the oncological properties of uterine leiomyosarcoma. However, in uterine rhabdomyosarcoma, LMP2/β1i-positive cells were clearly observed. Conclusion: It is expected that establishing a diagnostic and treatment method targeting characteristics of mesenchymal tumor cells will lead to the treatment of malignant tumors with a low risk of recurrence and metastasis.     

An extremely rare autopsy case of cardiac liposarcoma and Brenner tumor

A 79-year-old woman with primary liposarcoma of the heart, an extremely rare malignancy, coexistent with Brenner tumor was reported. The histological features of the sarcoma on the routine histological slides were so varied that it was necessary to differentiate the histology from that of malignant fibrous histiocytoma or pleomorphic rhabdomyosarcoma. Most of the tumor cells including fibroblastic and bizarre giant cells, however, were stained intensely with histochemical methods for lipids and consequently diagnosed as pleomorphic liposarcoma originated from the epicardium. Electron microscopically, lipid droplets were demonstrated in the cytoplasm of the tumor cells, supporting the histological diagnosis. No distant or nodal metastases were noted.     

扁桃体上皮样滤泡树突细胞肉瘤临床病理学分析

目的:探讨扁桃体上皮样滤泡树突细胞肉瘤(follicular dendritic cell sarcoma,FDC sarcoma)的临床病理学特点、免疫表型、超微结构以及鉴别诊断.方法:对1例发生于扁桃体的上皮样FDC肉瘤进行组织学观察、免疫组化标记及电镜观察.结果:患者女性,55岁.咽部不适感2年,近期症状加重而就诊.术中见左扁桃体肿大伴有糜烂.临床考虑为恶性淋巴瘤.镜下见瘤细胞形态较一致,由大上皮样细胞组成,未见梭形瘤细胞.瘤细胞境界不清,丰富的嗜酸性胞质,空泡状核,核仁明显.瘤细胞间散在小淋巴细胞浸润.免疫组化标记显示瘤细胞弥漫性表达vimentin、CD21、CD23、CXCL13和D2 - 40.电镜观察于瘤细胞胞浆内可见粗面内质网和线粒体,少量由桥粒连接的细胞突,明显的椭圆形核及核内的大核仁.肿块切除后随访4个月无复发及转移.结论:扁桃体上皮样亚型的滤泡树突细胞肉瘤非常罕见.诊断时应与多种具有上皮样形态的肿瘤鉴别.     

胆管葡萄状肉瘤3例临床病理特征

目的：探讨胆管葡萄状肉瘤,临床病理学特点和鉴别诊断,不同分化程度的胆管葡萄状肉瘤与预后的关系。方法：收集1990年4月～2004年10月间共3例胆管葡萄状肉瘤,复习临床资料,收集每例组织蜡块进行切片,HE染色、特殊组织化学染色及免疫组化染色观察分析。结果：本组3例发病年龄为14个月、5岁4个月、4岁。男2例、女1例。1例由胆总管蔓延至胆囊颈部,1例蔓延至肝门。瘤细胞及其排列具有特征性结构,在正常或伴有增生的粘膜下为未分化型肌母细胞即：＂形成层＂状,内部为粘液瘤样区域。细胞学特点是各种形态肿瘤细胞均有不同程度嗜酸胞浆。免疫组化：vimentin（＋）、desmin（＋）、actin（＋）、myoglobin（＋）。结论：胆管葡萄状肉瘤罕见,几乎均见于幼儿。高分化胆管葡萄状肉瘤易误诊为一些良性病变,延误治疗,需引起重视;低分化葡萄状肉瘤,则易误诊为恶性淋巴瘤等。本病具有侵袭性及远处转移,预后差。但目前手术、放、化疗效果满意,生存期较大。     

Leucocyte common antigen in the differential diagnosis of Hodgkin's disease

The utility of immunohistochemical staining for leukocyte common antigen (LCA) in the differential diagnosis of Hodgkin's disease was studied in a series of 42 cases of Hodgkin's and non-Hodgkin's lymphoma and compared with Leu M-1, a proposed marker for Reed-Sternberg cells. LCA staining of neoplastic cells was absent in 23 of 24 cases of Hodgkin's disease but present in 16 of 18 cases of non-Hodgkin's lymphoma including eight of 10 cases with pleomorphic Reed-Sternberg-like cells. Leu M-1, in contrast was present in 14 of 24 cases of Hodgkin's disease, but also in five of 18 cases of non-Hodgkin's lymphoma including five of 10 cases with pleomorphic Reed-Sternberg-like cells. Immunohistochemical staining for LCA appears useful in the differential diagnosis of Hodgkin's disease and appears to be a better discriminant than Leu M-1.     

颅内转移性腺泡状软组织肉瘤4例临床病理分析

背景与目的：腺泡状软组织肉瘤颅内转移少见,容易与颅内其他原发性肿瘤混淆。本研究探讨4例颅内转移性腺泡状软组织肉瘤的临床病理特点、鉴别诊断以及预后情况。方法：复习4例颅内转移性腺泡状软组织肉瘤的病理切片及临床资料,并做免疫组化染色及PAS特殊染色,抗体包括Actin、Vimentin、Myosin、Myoglobin、S-100、Desmin、CgA、Syn、NSE、CK。结果：4例患者临床症状均主要表现为头痛及视物模糊等。颅内转移性病变均位于后颅窝．与脑膜关系密切。显微镜下肿瘤细胞胞浆透亮或嗜伊红,核仁明显,呈腺泡状排列,周围绕以血窦样结构。免疫组化染色2例表达Actin、Desmin和S-100,1例Vimentin和NSE弱表达。PAS染色4例均为阳性。1例术后1年内死亡,1例术后27个月死亡,1例30个月死亡,另1例术后已生存半年,目前无肿瘤复发。结论：颅内转移性腺泡状软组织肉瘤多数为转移性,需要与脑膜瘤、黑色素肿瘤、腺泡状横纹肌肉瘤以及副节瘤鉴别。患者预后差,术后5年生存率较低。