骨原发性平滑肌肉瘤8例临床病理、免疫组化研究及文献复习

目的 探讨骨平滑肌肉瘤的临床病理、组织学类型以及各种免疫组化的表达。方法 对8例骨原发性平滑肌肉瘤的临床、组织病理和免疫组化结果进行分析，结果 患者的发病年龄28-67岁，平均44岁，病变部位多见于下肢长骨的干骺端，尤其是膝关节附近，骨平滑肌肉瘤的组织分型多为普通型，其次为多形性及上皮样型；8例有瘤均表达viment、SMA，3例表达desmin、S-100，1例vytokeratin异型表达，随访结果5例无瘤生存，2例转移，1例死于肿瘤复发和转移，结论 骨原发性平滑肌肉瘤比较少见，其组织发生可能来自血管中层平滑肌细胞，诊断主要依靠免疫组化及电镜。

Primary leiomyosarcoma of bone: clinicopathological and immunohistochemical studies of 8 cases and review of the literature

Objective To study the clinicopathologic features, histological typing and the expression of some related antigens of leiomyosarcoma in the bone. Methods Hematoxylin-Eosin and immunohistochemical stains were used to analyze histopathological and immunohistochemical changes of the tumor. Results Age of the patients ranged from 28 to 67 years ( mean 44 years). The predominant sites of occurrence were the metephyses of long bones, particularly the lower end of the femur and the upper end of the tibia. The most common histological type was the classic, followed by pleomorphic and epitheloid variants. Immunohistochemically, all the tumors reacted positively with smooth muscle actin and vimentin, and the expression of S 100 protein and desmin was found in 3 cases and cytokeratin in one case. The follow-up data showed that 5 patients survived without the tumor, two with metastasis and one died of recurrence and metastasis of the tumor. Conclusions Leiomyosarcoma of bone is rare and may derive from vascular smooth muscle cells. The diagnosis depends on immunohistochemistry and electron microscopy.