Epithelioid sarcoma: ultrastructural similarity to nodular synovitis.

The ultrastructure of nodular synovitis of the knee and epithelioid sarcoma of the hand are compared. Both lesions show a similar pattern of light and dark cells having filopodia and microvilli, an outer coat of finely granular matrix without well defined basal laminae, maculae adherentes and attachment sites, pinocytotic vesicles, cytoplasmic filaments and complex nuclear invaginations. These similarities suggest a common histogenesis and support the concept that the epithelioid sarcoma is derived from synovioblastic mesenchyme.     

Epithelioid sarcoma: case report with ultrastructural review, histogenetic discussion, and chemotherapeutic data.

A case of abdominal wall epithelioid sarcoma, studied by light and electron microscopy over a 3-year period, is presented. Ultrastructurally, there appear to be two types of tumor cells, light and dark, which differ by virtue of a heavier concentration of microfibrils and dilated rough endoplasmic reticulum in the dark cells. Both tumor cell types contain prominent Golgi systems, abundant free ribosomes, and numerous pinocytotic vesicles. The ultrastructural characteristics of the tumor cells resembel those of epithelioid cells of experimental human granulomas, as well as those of normal human synovium. A multifaceted relationship between histiocytes and synovial cells is demonstrated and it is concluded that the tumor is probably derived from mesenchymal reserve cells capable of differentiating a long histiocytic or synovial lines. Preliminary chemotherapeutic data are reviewed.     

Epithelioid sarcoma

In a 9-year period we treated 11 patients with an epithelioid sarcoma. Most patients were young adults. The tumour affected mainly the distal upper extremity (hand and fingers: four patients; wrist and forearm: three patients); one patient had an epithelioid sarcoma of the knee. Trunk localizations were seen in two patients and one patient presented with a vulva localization. Treatment consisted of surgery, regional isolation perfusion with doxorubicin (Adriamycin) or melphalan, radiation therapy, systemic chemotherapy or a combination of these modalities. Radical surgery in eight patients resulted in only two local recurrences. Locoregional metastases occurred in five patients. In five patients a therapeutic lymph node dissection was performed, in all instances followed by extensive recurrent disease. Distant metastases were seen in seven patients and mainly affected the skeleton (6x) and the lungs (4x); in the majority of cases these metastases occurred within a year after excision of the primary. Remissions following regional or systemic chemotherapy were not observed. At the time of analysis seven patients had died as a result of their epithelioid sarcoma; two patients were still alive with tumour 18 and 27 months after diagnosis. Only two patients remained tumour free for 17 and 65 months respectively following radical surgery, postoperative radiation therapy and (in one case) adjuvant chemotherapy. It is concluded that epithelioid sarcoma is a rare but exceedingly aggressive tumour. Since early diagnosis can only be auspicious, familiarity with the clinical features is of great importance.     

上皮样肉瘤的研究进展

上皮样肉瘤是一种少见的、组织起源未定的软组织恶性肿瘤。本病发病率很低,在软组织肉瘤中发生率小于1％,查阅近几十年的中外文文献,大部分为个案报道,很少有大宗病例分析,也正是由于其发病率很低,临床及病理医师对其认识欠缺,导致误诊误治非常常见,本文将对上皮样肉瘤的临床、病理、免疫组化等特点做一综述,旨在提高人们对上皮样肉瘤的认识。     

Epithelioid trophoblastic tumor: a clinicopathological and immunohistochemical study of seven cases

The objective of this study is to evaluate the clinicopathological features and immunohistochemical characteristics of epithelioid trophoblastic tumor (ETT). Seven cases of epithelioid trophoblastic tumor treated in the Women’s Hospital of Zhejiang University from 2004 September to 2008 December were retrospectively analyzed. Immunohistochemical study was performed. The most common presenting symptom was vaginal bleeding. Four patients had prior evidence of molar pregnancy and three patients presented with metastases. Mean age at diagnosis was 34.7 years. Mean pregnancy interval was 3.39 years. Human chorionic gonadotropin levels were 33.25–174315.5 IU/l. One case died from metastasis in lungs. The remaining six patients survived without recurrence. Immunohistochemistry revealed diffusely positive for CK18, and focally positive for β-hCG, HPL, Mel-CAM (CD146) and inhibin-alpha. Nuclear staining of Ki67 and p63 were seen. The confirmation of epithelioid trophoblastic tumor diagnosis is difficult before surgery. Surgical intervention is the recommended primary treatment.     

Dedifferentiated chondrosarcoma. An ultrastructural study

The light and electron microscopic features of a well-differentiated chondrosarcoma with dedifferentiated foci (dedifferentiated chondrosarcoma) is presented. Ultrastructurally, the cells of the dedifferentiated portion were embedded in a matrix containing numerous short bundles of collagen fibers; these cells showed dilated rough endoplasmic reticulum containing stippled material as well as poorly formed cell junctions and resembled the cells in the cartilaginous component. These findings contrast with those reported previously.     

Epithelioid cell's uterine leiomyoma uteri. A case report with immunohistochemical study

In the present report we refer to a rare case of uterine leiomyoma Uteri with epithelioid cells, characterized by an omogeneous light cell's structure and by a lymphangiomatous like histological aspect. An immunohistochemical study was carried out, using both endothelial and cell surface markers, as well as vascular markers. This study has allowed us to exclude the angiogenic origin of the neoplasm. It has, furthermore, revealed how the lymphangiomatous like histological aspect, even though being a peculiar component of the tumor, is to be put in relation with the epithelioid cells' layout, which has been evidenced by the immunohistochemistry to be of muscular nature.     

A CLINICAL AND ULTRASTRUCTURAL STUDY OF ACUTE ESOINOPHILIC LEUKEMIA

The present study analyses two cases with acuteimmature eosinophilic leukemia. The clinical, physical,laboratory and pathologic materials are discussed.There is an abnormal number of immature eosinophiliccells in the blood and bone marrow, usually accompaniedby anemia and thrombocytopenia. Especially the ultra-structural features include abnormal granules, asyn-chronous maturation of the nucleus and cytoplasm,dilated endoplasmic reticulum and more Conspicuousnucleoli. Differential count was more precise underelectron microscope than under light microscope. Thesefindings may be helpful for differential diagnosis andclassification.