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目的探讨低度恶性肌纤维母细胞肉瘤(LGMS)的临床病理特征及免疫组化特点。方法对3例LGMS临床资料、病理学形态及免疫组化进行分析。结果镜下肿瘤组织由轻、中度异型的长梭形/胖梭形肿瘤细胞组成,核分裂象2~3个/10HPF。瘤细胞束状排列,浸润周边脂肪组织或横纹肌组织,似侵袭性纤维瘤病或形成类似增生性肌炎中的棋盘样结构;部分区域细胞密度增加,呈交织束状或鱼骨样排列。免疫组化:3例梭形肿瘤细胞均vimentin和SMA(+),1例desmin(+);3例S-100、calponin、lysozyme、EMA和AE1/AE3均(-)。结论 LGMS是肌纤维母细胞分化的低度恶性间叶源性肿瘤,易复发,亦可转移,明确诊断需组织形态学与免疫组化相结合。
Objective To investigate the clinicopathological characteristics and immunohistochemical characteristics of low grade myofibroblastic sarcoma (LGMS). Methods 3 cases of LGMS clinical data, pathological morphology and immunohistochemistry were analyzed. Results Microscopically, the microscopic tumor consisted of light and moderately shaped long spindle / fat spindle tumor cells with mitotic figures of 2 to 3/10 HPF. Tumor cells arranged in a bundle, infiltration of peripheral adipose tissue or striated muscle tissue, like invasive fibromatosis or the formation of chessboard-like structure in a similar hyperplastic myositis; cell density increased in some areas, were interwoven bundle or fishbone-like arrangement. Immunohistochemistry showed that vimentin and SMA (+) and desmin (+) were all found in 3 cases of spindle cell tumor. There were 3 cases of S-100, calponin, lysozyme, EMA and AE1 / AE3 in all three cases. Conclusion LGMS is a low-grade mesenchymal tumor differentiated by myofibroblasts. It is easy to relapse and metastasize. It is clear that LGMS combined with histomorphology and immunohistochemistry.