上皮样肉瘤

报告1例上皮样肉瘤.患者男,19岁.右侧臀部出现结节并渐增多伴破溃4个月来诊.皮损组织病理检查显示真皮及皮下组织内有一肿瘤浸润,瘤细胞由上皮样细胞和梭形细胞构成,部分细胞有异形性,瘤团内见小的坏死灶.免疫组化染色显示肿瘤细胞表达角蛋白(CK)和波形蛋白(VIM),而不表达CD34、平滑肌肌动蛋白(SMA)、上皮膜抗原(EMA)、S-100蛋白及CD68.患者的临床表现、组织病理改变及免疫组化染色均符合上皮样肉瘤的特点.     

上皮样肉瘤

报告1例跖部上皮样肉瘤.患者男,40岁.右足跖部结节2年,溃疡4～5个月.皮肤科检查:右足跖中央一5 cm×2 cm、深约1 cm的溃疡,周边少许肉芽样组织生长.皮损组织病理检查:真皮中下部可见栅状肉芽肿样瘤细胞团块,中央有坏死表现,周边主要由上皮样细胞和梭形细胞组成,核分裂象增多.免疫组化染色显示肿瘤细胞表达细胞角蛋白(CK)、上皮膜抗原(EMA)、波形蛋白(vimentin)和CD34,而不表达CD31和S-100蛋白.患者的临床表现、组织病理改变及免疫组化染色均符合上皮样肉瘤的特点.     

头部上皮样肉瘤

报告1例头部上皮样肉瘤。患者女，30岁。右侧颞部结节11年，溃疡1个月。皮肤科检查：右侧颞部见一2.5cm×2.5cm大、深约1cm的溃疡，中央表面结深黑色痂，周围有脓性分泌物。皮损组织病理检查：真皮中下部胶原间有结节状和交错排列的上皮样细胞团块，可见较多核分裂相，部分团块有坏死和裂隙样结构形成、间质中有许多淋巴细胞及少量细胞浸润。免疫组化染色结果示肿瘤细胞角蛋白（CK）、上质膜抗原（EMA）、波形蛋白（vim）、CD34均阳性。     

上皮样肉瘤1例

报告1例上皮样肉瘤.患者男,54岁,右下腹及腹股沟出现多发性肿物10年,组织病理检查示真皮肿瘤团块呈结节状分布,结节由多数上皮样细胞和少数梭形细胞组成,中央有小灶性坏死.免疫组化染色结果显示细胞角蛋白( ),波形蛋白( ),说明本病具有向上皮组织和间叶组织分化的特点,且以向上皮分化占优势.     

上皮样肉瘤1例

<正>患者女,44岁,因右前臂皮下结节、溃疡3年于2016年7月28日就诊于我科。患者3年前无明显诱因下出现右前臂近端屈侧一约黄豆大皮下结节,质地韧,活动度差,局部皮肤无红肿破溃,无自觉症状,未就诊未治疗。1年前原有皮疹周围出现一新发结节,约蚕豆大,局部有红肿,无破溃,至外院行皮肤活检,组织病理检查提示表皮大致正常,真皮内血管周围小片状淋巴细胞,仅见少量皮下脂肪组织,其内细血管周围稀疏淋巴细胞浸润,结合     

上皮样肉瘤1例

患者男,19岁。右小腿皮疹伴疼痛1年,皮疹切除术后约3个月时右足底部出现皮疹,伴疼痛,部分破溃。组织病理示肿瘤团块呈结节状,结节由上皮样细胞及呈漩涡状排列的梭形细胞组成。免疫组化示波形蛋白(+),EMA(+)。诊断:上皮样肉瘤。     

上皮样肉瘤1例

患者男,26岁。左上肢多发性结节、溃疡4年。皮肤组织病理检查示:真皮肿瘤团块呈结节状分布,结节由多数上皮细胞样细胞和少数梭形细胞组成,中央有大片状坏死区。免疫组化染色结果示:EMA(2+),波形蛋白(2+),CD34(+),CK(2+)。诊断为上皮样肉瘤     

上皮样肉瘤1例

报告1例皮肤上皮样肉瘤,患者男,42岁,右胫前皮肤硬肿块伴疼痛12年,破溃2年,双侧腹股沟淋巴结肿大5年,皮损及淋巴结组织病理检查示上皮样细胞殿堂增生呈团块状或条索状分布,细胞民形性明显,见核丝分裂像.免疫组化检查波形蛋白( ),AE1( ).     

上皮样肉瘤1例

患者男,61岁。左上肢多发性结节2年。皮损组织病理示:瘤组织位于真皮层,呈结节状,结节中心坏死,坏死周边肿瘤细胞呈上皮样或梭形,核分裂相易见。免疫组化染色示:CK(2+),EMA(2+),Vim(+),CD34(3+),CD31(+)。诊断:上皮样肉瘤。     

上皮样血管肉瘤

报告1例上皮样血管肉瘤.患者男,61岁.头顶部出现褐红色斑片1年,额部、双眼睑弥漫分布黄褐色斑片,局部皮肤肿胀半年.曾行外科治疗,疗后局部皮肤萎缩,头发稀少.经皮损组织病理及免疫组化染色证实为上皮样血管肉瘤.     

近端型上皮样肉瘤一例

患者男,66岁.患者自2个月前偶尔于右前臂、右大腿皮下触及肿块,表面皮肤未破溃,包块逐渐增大,无自觉症状,自发病以来,无发热史,体重正常.体检:各系统均正常,全身其余部位未触及硬结及异常.皮肤科检查:右前臂及右大腿皮下可分别触及单发的质硬结节,无压痛,表面皮肤无破溃,硬结表面皮肤与周嗣皮肤颜色无异常.实验室检查:血尿常规、生化系列及免疫常规均正常.行外科手术切除活检,术中所见,右前臂及右大腿皮下近筋膜组织处肿块,活动度差.     

Epidermotropic metastatic epithelioid sarcoma: a potential diagnostic pitfall

Epithelioid sarcoma (ES) represents an aggressive soft tissue tumor with varied morphologic and histopathologic presentations that typically elicits a broad differential diagnosis, including granuloma annulare, necrobiotic granuloma, fibrous histiocytoma, synovial sarcoma, amelanotic melanoma and poorly differentiated primary cutaneous and metastatic adenocarcinoma. ES is characterized microscopically by a nodular arrangement of abundant, deeply eosinophilic, polygonal tumor cells with frequent central necrosis and hemorrhage, rare mitotic figures and minimal pleomorphism. At the periphery, tumor cells are spindle shaped and may exhibit frequent local infiltration along tendons, fascial planes and neurovascular bundles. Immunohistochemistry typically reveals expression of both epithelial and mesenchymal antigens, such as cytokeratin and vimentin, respectively. The absence of a connection between tumor cells and the overlying epidermis, with or without an in situ carcinoma component, typically rules out a primary cutaneous squamous cell carcinoma. We report a case of stage IV proximal‐type ES that mimicked molluscum contagiosum clinically and was histopathologically reminiscent of invasive squamous cell carcinoma because of attachment and colonization of the overlying epidermis. The case represents an unusual pathologic presentation of ES and highlights potential pitfalls in establishing the diagnosis.     

Comparative genomic hybridization in epithelioid sarcoma

BACKGROUND: Epithelioid sarcoma is a rare mesenchymal neoplasm of unknown histogenesis. Data on genome-wide surveys for chromosomal aberrations in epithelioid sarcoma are limited. OBJECTIVES: To investigate genetic aberrations in epithelioid sarcoma. METHODS: We analysed seven cases of epithelioid sarcoma (classic type, three cases and proximal type, four cases) by comparative genomic hybridization (CGH), and correlated findings with the results of additional immunohistochemical study. RESULTS AND CONCLUSIONS: CGH analysis showed DNA copy number changes at one to five different genomic sites in six of seven cases (86%). The majority of the changes were gains. The most frequent gain was at 22q (six cases). Other recurrent changes include gains of 12q24-qter (four cases), 17 (four cases), and 5q32-qter (three cases). High-level homology was seen in chromosomal aberration in both types. In addition, expression of interleukin-2 receptorbeta, located in 22q, was revealed by immunohistochemical method in six cases with gain of 22q, suggesting it may play a role in epithelioid sarcoma tumorigenesis.     

上皮样肉瘤9例临床分析

回顾性分析9例上皮样肉瘤的临床资料,患者平均年龄43.8岁,6例皮损位于上肢,1例位于胸部,1例位于足跟部,1例位于肩部。肿瘤直径1 cm者4例,1~5 cm者5例。病理特征表现为表皮角化过度,棘层增生肥厚;真皮内可见大量上皮样细胞增生,可见细胞异型。免疫组化染色显示,所有患者细胞角蛋白(CK)、波形蛋白(VIM)及上皮膜抗原(EMA)表达阳性,3例患者CD34表达阳性。所有患者均在外科行手术切除,6例术后辅助放疗及化疗。6例患者随访24.8个月复发4例。     

Disseminated Kaposi sarcoma with epithelioid morphology in an HIV/AIDS patient: A previously unreported variant

Kaposi sarcoma is an oligoclonal HHV‐8‐driven vascular proliferation that was first described by a Viennese dermatologist Dr Moritz Kaposi. The disease has been seen in different clinical‐epidemiological settings with a wide morphologic spectrum. We report a 52‐year‐old Caucasian man with HIV/AIDS and Kaposi sarcoma who presented with dyspnea and pleural effusion. He reported numerous tender subcutaneous nodules developing over the past few months on his chest, back and abdomen. An excisional biopsy of one of the nodules was performed. Touch preps revealed malignant cells in clusters. Microscopically, the neoplasm appeared undifferentiated with an epithelioid morphology, and involved the dermis and subcutaneous fat. Despite the medical history, Kaposi sarcoma was not considered foremost in the differential diagnosis. The malignant cells were positive for vimentin and negative for S100 protein, keratin AE1/3, CK7, CK20, napsin A, TTF‐1 and synaptophysin. Additional stains revealed positivity for HHV‐8, CD31 and D2‐40, supporting the diagnosis of Kaposi sarcoma. Kaposi sarcoma has been well described with many variants that may cause diagnostic difficulty. An epithelioid variant has not been reported and consequently, may cause misinterpretation of an otherwise well‐known entity that may become life threatening if appropriate treatment is not initiated in a timely manner.     

上皮样肉瘤的临床与病理分析

目的:探讨上皮样肉瘤的临床,病理学特征及鉴别诊断要点.方法:收信9例上皮样肉瘤患者资料,观察和分析其临床和组织病理学特征,并通过免疫组化方法分析其细胞角蛋白(GK),上皮膜抗原(EMA),波形蛋白(Vim)、S-100蛋白、CD34及平滑肌肌动蛋白（SMA）的表达。结果：该肿瘤由上皮样细胞和梭形细胞构成，肿瘤细胞有一定异形性，可以表达GK、EMA、Vim、S-100蛋白、CD34及SMA。结论：上皮样肉瘤是恶性肿瘤，免疫组化有助于确定肿瘤是上皮细胞来源。在临床和组织病理上本病需与其他肿瘤和肉芽肿鉴别。