滑膜软骨肉瘤临床病理观察

目的 探讨滑膜软骨肉瘤的临床病理特点及鉴别诊断要点.方法 对1例滑膜软骨肉瘤进行临床病理观察并行免疫组化标记.结果 肿瘤位于关节腔内,呈不规则分叶状；切面灰白、灰蓝色,质脆,部分区域灰红色、质软.镜下见软骨细胞片状分布,伴有细胞不典型性；大部分区域软骨细胞分化较差,呈梭形,核仁大而明显,可见双核、大核及异型核的肿瘤细胞,局灶坏死明显,病理性核分裂多见.免疫组化:S-100和vimentin(+).结论 滑膜软骨肉瘤非常罕见,临床上主要应与滑膜软骨瘤病及色素沉着绒毛结节性滑膜炎等鉴别,组织学上可分为原发型和继发型,确诊需结合临床病史、影像学、手术所见及组织学形态综合判断分析.

Synovial chondrosarcoma:a clinicopathologic analysis

Objective To study the clinical pathological characteristics and differential diagnosis of synovial chondrosarcoma.Methods One case of synovial chondrosarcoma was studied by clinical data analysis,light microscopy and immunohistochemistry.Results The specimen consisted of multiple,irregular white,pink and brittle fragments of tissue with a grayish-white and grayish-blue surface,pink and brittle fragments of tissue with a grayish-white and grayish-blue surface,which was within the articular cavity.Under high power microscope,sheets of atypical appearing chondrocytes were seen.In most areas,the cartilaginous tissue was composed of irregular cells with prominent nucleolus.The chondrocytes exhibited pleomorphism,with hyperchromatic,bizarre,or giant nuclei.Mitoses,binucleated cells and foci of necrosis were often seen.Immunohistochemically,the neoplastic cells were positive for S-100 and vimentin.Conclusions The synovial chondrosarcoma is rare.It should be identified from synovial osteochondromatosis,villonodular synovitis,vilonodular synovitis and so on.It is histologically divided into primary and secondary type.The diagnosis should be made by manifestations of clinical history,imaging and pathological examination.