指状树突细胞肉瘤／肿瘤的临床病理观察  

Interdigltating dendritic cell sarcoma/tumor： a study of 3 cases

作　　者：甘梅富[1] 卢洪胜[1] 张建伟[1] 余心如[2] 

机构地区：[1]浙江省台州医院病理科,临海317000 [2]浙江大学医学院附属第一医院病理科

出　　处：《中华病理学杂志》2008年第10期676-679,共4页Chinese Journal of Pathology

摘　　要：目的探讨指状树突细胞肉瘤／肿瘤（IDCS）的病理特征、诊断及鉴别诊断。方法分析3例IDCS的临床表现，对标本进行病理形态和免疫组织化学（EnVision法）染色观察。结果大体检查肿瘤呈灰白、灰黄色，质实。1例发生于左肺，1例原发于脾脏伴全身淋巴结累及，1例发生于淋巴结。光镜下肿瘤组织呈边界不甚清楚的巢片状，部分呈束状、旋涡状排列，周边较多淋巴细胞、浆细胞浸润。肿瘤细胞呈卵圆形或梭形，胞质透亮或轻度嗜酸性，核卵圆形，呈空泡状，可见不明显的小核仁，部分见有核沟。免疫组织化学肿瘤细胞表达S-100蛋白。结论IDCS是一种罕见的组织细胞和树突细胞恶性肿瘤，有一定的病理学特征。应与滤泡树突细胞肉瘤、炎性假瘤、朗格汉斯细胞组织细胞增生症、恶性黑色素瘤、未分化癌及间变性大细胞淋巴瘤等鉴别。免疫组织化学S-100蛋白等标记对鉴别诊断有帮助。Objective To study the pathologic features, diagnosis and differential diagnosis of interdigitating dendritic cell sarcoma （IDCS）. Methods The clinical findings, morphologic features and immunophenotype of 3 cases of IDCS were investigated. Results Gross examination showed that IDCS had a greyish-white to greyish-yellow cut surface. The site of occurrence included lung, spleen （with lymph node metastasis） and lymph node. Histologically, the tumor cells were arranged in nests, fascicles and whorls, with intimate admixture of many lymphoeytes and plasma cells. They were oval to spindle in shape and contained pale eosinophilic cytoplasm, oval and sometimes grooved nuclei, small distinct nucleoli and illdefined cell borders. Immunohistochemical study showed that the tumor cells expressed S-100 protein. Conclusions IDCS is a rare type of histiocytic and dendritic cell malignancy with distinctive morphologic findings. It needs to be distinguished from follicular dendritic cell sarcoma, inflammatory pseudotumor, Langerhans＇ cell histiocytosis, malignant melanoma, undifferentiated carcinoma and anaplastic large cell lymphoma staining for S-100 protein is helpful in confirming the diagnosis

关 键 词：淋巴系统疾病 肉瘤 树突细胞 诊断 鉴别 

分 类 号：R686[医药卫生—骨科学]