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目的探讨心骨肉瘤临床病理特征,以提高对该肿瘤的认识。方法对1例心骨肉瘤进行形态学和免疫组化观察,并结合临床资料复习相关文献。结果镜下可见肿瘤细胞弥漫分布,细胞形态多样,大小不一,异型性明显,主要为短梭形,细胞部分呈多边形、椭圆及上皮样。肿瘤细胞周围可见大量金属丝样及花边状排列均质粉染的骨样基质。免疫组化:vimentin(+),SMA、actin、EMA、AE1/AE3、CD34、CD117、calretinin和S-100均(-)。结论原发性心骨肉瘤非常罕见,诊断关键在于准确识别肿瘤性骨样基质,免疫组化有助于鉴别诊断。首先应排除心转移性骨肉瘤。
Objective To investigate the clinicopathological features of osteosarcoma in order to improve its understanding of the tumor. Methods One case of cardiac osteosarcoma was observed by morphology and immunohistochemistry, and the related literature was reviewed with clinical data. Results The tumor cells were diffusely distributed under the microscope. The cells varied in shape and size, with obvious atypia. They were mainly short fusiform, and the cells were polygonal, oval and epithelial. Around the tumor cells can be seen a large number of wire-like and lace-like arrangement of homogeneous powder-like bone-like matrix. Immunohistochemistry: vimentin (+), SMA, actin, EMA, AE1 / AE3, CD34, CD117, calretinin and S-100 (-). Conclusions Primary osteosarcoma is very rare. The key point of diagnosis is accurate identification of tumorous bone matrix. Immunohistochemistry is helpful for differential diagnosis. Should first rule out cardiac metastatic osteosarcoma.