食管肉瘤样癌临床病理和免疫组化分析

目的 :观察食管肉瘤样癌 (sar comatoidcarcinoma ,SC)的临床病理特点和免疫组织化学表达 ,探讨其可能的组织起源。方法 :采用光镜观察和免疫组化标记 ,对 4例食管SC进行回顾性研究。结果 :SC多见于 5 0岁以上的男性。主要症状为进行性吞咽困难和胸骨后疼痛。肿瘤多呈息肉样或蕈样 ,表现为癌和梭形细胞肉瘤双相形态特征 ,癌和肉瘤组织相互之间可见移行过渡。免疫组化 ,4例SC中的癌成分对上皮性标记物CK和EMA均呈阳性表达 ,对间叶性标记物Vimentin表达阳性 1例 ;肉瘤成分Vimentin表达阳性 3例 ,弱阳性 1例 ,部分瘤细胞S 10 0蛋白表达阳性 2例 ,SMA阳性 1例 ;同时对CK或EMA表达阳性各 1例。结论 :食管SC是一种不同于食管其他型癌的少见的恶性肿瘤 ,肉瘤样癌细胞的双重形态表象可能是癌细胞多向转化的结果

Sarcomatoid carcinoma of the esophagus:a clinicopathological and immunohistochemical analysis

OBJECTIVE:To explore the clinicopathological and immunohistochemical features as well as the histogenesis of esophageal sarcomatoid carcinoma(SC).METHODS: Four cases of the esophageal SC were studied by histopathological observation and immunohistochemical staining.RESULTS: Three patients were male and 1 was female ranging in age from 44 to 69 years old (mean, 58.7 yr ). The major symptoms of the patients were progressive dysphagia and pain behind the sternum. Grossly, the tumors in 3 cases showed polypoid or fungiform in shape and protruded into the lumen of the esophagus with a short narrow pedicle, remaining 1 showed a giant ulcer. Microscopically, both carcinomatous and sarcomatous components were seen and transited each other. The sarcomatous elements formed the major part of the tumors. Immunohistochemically, the carcinomatous elements were positive for CK and EMA. The sarcomatous elements were positive for vimentin in 3 cases and for S-100 protein in the partial tumor cells in 2 cases, simultaneously positive for CK or EMA in 1 case.CONCLUSIONS: The esophageal SC is a rare malignant tumor that differs from the other type of esophageal carcinomas. The double phenotypes of the tumor may result from the cancer cell transforming to multi-direction.