左腹股沟淋巴结内指突状树突细胞肉瘤1例报告并文献复习  

Interdigitating dendritic cell sarcoma in the inguinal lymph node:a case report with review of literature

作　　者：范宜娟[1] 李小强[2] 杜光烨[2] 杨滢瑜[1] 陈荣[1] 章林培[1] 

机构地区：[1]上海复旦大学附属华山医院宝山分院病理科,上海200431 [2]上海交通大学附属第三人民医院病理科,上海201900

出　　处：《现代肿瘤医学》2009年第2期325-328,共4页Journal of Modern Oncology

摘　　要：目的:探讨淋巴结内指突状树突细胞肉瘤的临床病理特征、诊断要点及鉴别诊断。方法:对1例腹股沟淋巴结内指突状树突细胞肉瘤进行组织病理学和免疫组化染色观察并随访,结合文献进行讨论。结果:镜下显示淋巴结结构破坏,细胞呈梭形、圆形、椭圆形,肿瘤细胞弥漫分布,异性型明显,可见核分裂象,经化疗后肿瘤内可见片状凝固性坏死。免疫表型:瘤细胞表达Vimentin、CD68和S-100蛋白。结论:淋巴结内指突状树突状细胞肉瘤是一种罕见的免疫辅助细胞恶性肿瘤。其诊断依靠组织病理学和免疫组化染色,必要时电镜辅助诊断。应与滤泡树突细胞肉瘤、朗格汉斯细胞组织细胞增生症、恶性纤维组织细胞肉瘤、恶性黑色素瘤、间变性梭形细胞癌及其他肉瘤鉴别。治疗以手术切除为主,辅以化疗和(或)放疗,预后差。Objective：To study the clinicopathologic features,diagnosis and differential diagnosis of interdigitating dendritic cell sarcoma（IDCS）. Methods：One case of IDCS in the inguinal lymph node was evaluated by light microscopy and immunohistochemistry. Results： Microscopically, the lymph node structure was destroyed, the tumor displayed a characteristic biphasic pattern which was composed of plump spindle - shaped, round or oral cells . The neoplastic cells exhibited a magnificent degree of nuclear atypia, with occasionally identified mitotic figures. After medical treatment, coagulative necrosis was observed ,The neoplastic cells were positive for Vimentin, CD68, and S -100 protein. Conclusion：IDCS is a rare malignant tumor with poor prognosis, electron microscopy and immunohistochemistry are necessary for the diagnosis. IDCS should be treated by complete excision with adjuvant chemotherapy or radiotherapy if necessary, and differential diagnosis includes follicular dendritic cell sarcoma, Langerhans cell histiocytosis, malignant fibrous histiocytoma, melanoma, metastatic spindle cell carcinoma and other sarcomas.

关 键 词：腹股沟肿瘤 指突状树突细胞肿瘤 淋巴结 免疫组化 诊断 鉴别诊断 

分 类 号：R730.3[医药卫生—肿瘤]