24 例软组织透明细胞肉瘤的病理组织学及免疫组化观察

 目的 探讨透明细胞肉瘤的临床病理特点及诊断与鉴别诊断要点。方法 观察24例透明细胞肉瘤的病理形态及免疫组织化学特征。结果 显微镜下肿瘤主要由胞质丰富而透明的多角形或梭形细胞组成，其被纤维组织分隔呈大小不等的巢状或柬状。部分病例中可出现多核巨细胞、细胞外黏液样物质、裂隙、细胞内黑色素颗粒、出血坏死及囊性变。免疫组织化学方面：肿瘤中Vimentin、S-100、HMB45、CK的阳性表达率分别为100％（24／24）、91．66％（22／24），70．82％（17／24）、16．66％（4／24），而EMA均为阴性表达。结论 透明细胞肉瘤预后不良，属于中度恶性肿瘤。

Patholoical Features and Immunohistochemistry Observation of 24 Cases Clear Cell Sarcoma of Soft Tissue

Objective 　To investigate the clinicopathological characteristics and the emphasis of diagnosis and differentiation diagnosis of clear cell sarcoma. Methods 　The pathomorphology and immunohistochemistry features were observed in 24 cases of clear cell sarcoma. Results 　Microscopic , tumor was composed mainly of polygonal or spindle-shaped cells with abundant clear cytoplasm and separated by fibrous septa into nest s or cords of different sizes. Multinucleated giant cells、ext racellular mucoid substance 、int racellular brown malanin、haemorrhage and/ or necrosis and cystis degeneration may present in part of cases. Immunohistochemistry : Positivity for Vimentin 、S-100 、HMB45 and Ck was seen in 100 % 24/ 24) 、91. 66 %(22/ 24) 、70. 82 %(17/ 24) 、16. 66 %(4/ 24) , respectively. And it was negative for EMA expression (0/ 24) . Conclusion 　The prognosis of clear cell sarcoma is poor , and this disease should belonged to moderate malignant tumor.