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目的探讨上皮样肉瘤的临床病理特征及诊断与鉴别诊断。方法分析5例上皮样肉瘤的临床病理特征并进行文献复习。结果5例均为手术切除标本,均位于四肢。镜下均呈特征性结节性生长。肿瘤细胞有两种形态:一类为大的多角形或卵圆形细胞,胞质丰富,嗜伊红,类似上皮样细胞;另一类为梭形细胞,丰满似纤维母细胞样,两种细胞逐渐移行。免疫组化示肿瘤细胞vimentin、CK、EMA、CD34、S-100呈不同程度(+)。结论上皮样肉瘤是一种少见的独特的病变,典型病例诊断不难。对取材较少或镜下表现不典型,尤其是结节中心坏死较小甚至无坏死时,易与滑膜肉瘤、上皮样血管内皮瘤、上皮样恶性神经鞘瘤等混淆,需综合临床资料、镜下特点及免疫组化等特点进行鉴别。
Objective To investigate the clinicopathological characteristics, diagnosis and differential diagnosis of epithelioid sarcoma. Methods The clinical and pathological features of 5 cases of epithelioid sarcoma were analyzed and reviewed. Results All 5 cases were resected specimens, all located in the extremities. Microscopic showed characteristic nodular growth. Tumor cells have two forms: a large polygonal or oval cells, cytoplasm rich, eosinophil, similar to epithelial-like cells; the other is spindle cells, full like fibroblast-like, two Cells gradually migrate. Immunohistochemistry showed that the tumor cells vimentin, CK, EMA, CD34, S-100 showed varying degrees (+). Conclusion Epithelioid sarcoma is a rare and unique disease, the diagnosis of typical cases is not difficult. Of the less material or microscopic performance of atypical, especially the small or no necrosis of the center of nodules, easy synovial sarcoma, epithelioid hemangioendothelioma, epithelial malignant schwannoma, etc. confused, the need for comprehensive clinical data, Microscopic features and immunohistochemical characteristics of identification.