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目的分析原发及其复发的肝未分化肉瘤的临床和病理变化,明确其组织学特点及复发后的病理改变。方法结合文献,对1例罕见的肝未分化肉瘤的原发及其3次复发病例进行临床及病理形态分析,用S-P法进行免疫组化研究。结果肝未分化肉瘤无特殊的临床表现;影像学改变多为囊性或囊实混合性;组织学图象是由梭形和上皮样的原始间叶细胞、多核巨细胞、PAS阳性的嗜酸小体组成,免疫组化显示Vimentin(+),AACT(+),Desmin(+),Actin(+)。在原发性肿瘤中出现了腺体结构,而在其3次复发的病例中,未见到腺体。结论警惕肝囊性或囊实混合性病变;肝未分化肉瘤内的腺体成分可能是肝胆管的残留和反应性增生;肿瘤可向平滑肌、横纹肌及纤维组织细胞分化。
Objective To analyze the clinical and pathological changes of primary undirected hepatocellular undifferentiated sarcoma and clarify its histological characteristics and pathological changes after relapse. Methods According to the literature, the primary and three recurrences of one case of undifferentiated liver sarcoma were analyzed clinically and pathologically, and immunohistochemistry was performed by S-P method. Results The undifferentiated sarcoma had no special clinical manifestations. Most of the changes were cystic or cystic and solidified. Histological images consisted of fusiform and epithelial primitive mesenchymal cells, multinucleated giant cells, PAS-positive eosinophils Body composition, immunohistochemistry showed Vimentin (+), AACT (+), Desmin (+), Actin (+). The glandular structure appeared in the primary tumor, whereas in its 3 recurrent cases, no gland was seen. Conclusion Vigilant liver cystic or cystic solid mixed lesions; liver undifferentiated sarcoma glandular components may be residual and reactive hepatobiliary proliferation; tumor to the smooth muscle, striated muscle and fibrous tissue cells.