血管周肌细胞瘤的临床病理特点  

Clinicopathologic characteristics of myopericytoma

作　　者：朱延波[1] 蔚青[1] 袁菲[1] 金晓龙[1] 

机构地区：[1]上海第二医科大学瑞金医院病理科,200025

出　　处：《中华病理学杂志》2005年第5期279-282,共4页Chinese Journal of Pathology

摘　　要：目的探讨血管周肌细胞瘤的临床病理特点.方法对6例血管周肌细胞瘤的临床病理和免疫组织化学(LSAB法)进行分析[抗体包括上皮膜抗原、细胞角蛋白(CK)、S-100、平滑肌肌动蛋白(SMA)、结蛋白、CD31、CD34].结果男性3例,女性3例,年龄16～58岁,肿块位于四肢、胸部.肿瘤无包膜,圆形和梭形的肌样细胞围绕血管多层同心圆生长,部分基质黏液样,有的呈肌纤维瘤病图像,有的呈血管外皮瘤样,有的呈血管球瘤样,其中1例肿瘤细胞在血管内生长;1例出现异形肿瘤细胞,片状坏死和出血,核分裂象增多,为恶性血管周肌细胞瘤.肿瘤细胞均表达SMA,而CD34、 CD31、S-100、CK均阴性.结论血管周肌细胞瘤是以肌样细胞围绕血管同心圆生长为特点的一组形态多样的肿瘤,它向血管周围肌样细胞或称肌周细胞分化,极少数可以是恶性血管周肌细胞瘤.Objective To investigate the clinicopathologic characteristics and differential diagnosis of myopericytoma. Methods Six cases of myopericytomas were analyzed by light microscopy and immunohistochemistry (LSAB detection method). Results Tumors from 3 females and 3 males were found on the extremities and chest wall. The ages of these 6 patients ranged from 16 to 58 years. Histologically, all tumors were unencapsulated. The neoplastic cells were oval to spindle shaped with eosinophilic cytoplasm, had a myoid appearance and showd areas of concentric perivascular proliferation around lesional blood vessels which were present with focal myxoid stroma. Morphologically in some cases the tumor overlap myofibroma, hemangiopericytoma or glomus tumor. One tumor was located entirely within the lumen of a vein. In another case, the tumor displayed cellular pleomorphism, mitotic activity, necrosis should be diagnosed as malignant myopericytoma. The neoplastic cells were positive for SMA and negative for CD31, CD34, S-100, and CK. Conclusions Myopericytoma is composed of oval to spindle shaped myoid cells with a striking tendeny for concentric perivascular growth. These cells differentiate towards perivascular myoid cells or myopericytes. Extremely rare malignant myopericytoma exist.

关 键 词：血管周肌细胞瘤 临床病理 肿瘤 抗体 

分 类 号：R732.2[医药卫生—肿瘤] R36[医药卫生—临床医学]