去分化型脂肪肉瘤的临床病理——附2例报告及文献复习  

Clinicopathological study on dedifferentiated liposarcoma: report of two cases and review of literature

作　　者：付静[1] 王琰 张仁亚[3] 苏怀勇 

机构地区：[1]山东聊城市人民医院病理科,山东聊城252000 [2]山西阳谷县人民医院 [3]山东省济宁医学院附院

出　　处：《罕少疾病杂志》2006年第1期16-18,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的探讨去分化型脂肪肉瘤的临床病理特点、诊断和鉴别诊断要点。方法报告2例发生于四肢软组织去分化型脂肪肉瘤患者的临床和病理资料,并复习相关文献。结果例1男,59岁,左上臂肿胀2个月余,无明显疼痛;例2女,62岁,右股部肿物1个月余。2例均予单纯肿瘤切除术,术后随访3个月和6个月,肿瘤无复发。病理检查见分化好的脂肪肉瘤和高度恶性非脂肪源性的肉瘤并存,分化好的区域含有脂肪瘤样、硬化性或者粘液样脂肪肉瘤成分,非脂肪源性肉瘤成分类似于恶性纤维组织细胞瘤,两者有明显的移行。免疫组织化学染色显示:瘤细胞S-100蛋白、CD34阳性,CD68、SMA、CD31、Actin阴性。结论去分化型脂肪肉瘤具有较高的复发率,易误诊为恶性纤维组织细胞瘤,其诊断主要依据组织病理学,外科手术切除是主要的治疗手段。Objective To investigate the clinicopathologic characteristics, diagnosis and differential diagnosis of dedifferentiated liposarcoma. Methods The clinical data and pathological findings of two patients with dedifferentiated liposarcoma were analyzed retrospectively, and the related literature was reviewed. Results The 59-year-old man complained of painless swelling of the left arm for more than two months. The 62-year-old woman complained of mass in the right leg for more than one month. The resection of lump was performed in both two patients. In the period of following-up with three months or six months, the tumor didn recur. Morphologically, the carcinoma cells showed areas with high grade nonlipogenic sarcoma juxtaposed to a well differentiated liposarcoma. The transition between two components was found. The well-differentiated areas might be of a lipoma-like, sclerosing or mixed type, and the dedifferentiated areas most frequently were of malignant fibrous hystiocytoma-like type. Immunohistochemically, the tumor cells presented with strongly positive reaction for S- 100 protein and CD34, but negative for CD68, SMA, CD31 and Actin. ConeluMon Dedifferentiated liposarcoma is not only of high recurrence rate, but also misdiagnosed as malignant fibrous histiocytoma easily. The comfirmed diagnosis depends on histopathology. The resection of tumor is the best choice for the treatment of dedifferentiated liposarcoma.

关 键 词：去分化型脂肪肉瘤 免疫组织化学 病理学 

分 类 号：R730.262[医药卫生—肿瘤] R392.31[医药卫生—临床医学]