一例原发性脾组织细胞肉瘤患者临床病理观察及文献复习  

Clinicopathological features of primary splenic histiocytic sarcoma：a case report and literature review

作　　者：张颖春[1] 于霄[1] 李平[2] 赵俊军[1] 孙雷[1] 王波[1] 

机构地区：[1]大连医科大学中日临床病理中心,116044 [2]大连市中心医院病理科

出　　处：《中华血液学杂志》2010年第10期663-666,共4页Chinese Journal of Hematology

摘　　要：目的 探讨脾组织细胞肉瘤（HS）的发生、临床病理特征及预后.方法 对1例脾HS患者进行病理组织形态学、免疫组化分析,并复习相关国内外文献.结果 患者,女,69岁,无明显诱因出现乏力、劳累后心悸1个月.CT示脾脏肿大、脾脏多发占位.术中见脾脏大小约28 cm × 18 cm ×10 cm,呈紫红色结节样改变.显微镜下见脾脏病理组织脾窦扩张,肿瘤细胞弥漫分布,界限清楚,大部分核呈多形性,核仁明显.胞质丰富,多呈嗜酸性,空泡和噬血细胞现象可见.免疫组化检查示CD68^＋、CD163^＋、LCA^＋、Vim^＋、CD1α^-、S-100^-、CD30^-、CK^-、CD20^-、CD3^-、CD21^-.结论 脾脏HS罕见,患者大多预后不良,免疫组化检查对于疾病的诊断起重要作用.Objective To study the clinicopathological features of primary splenic histiocytic sarcoma.Methods Clinicopathological characterstics were analyzed in a case of primary splenic histiocytic sarcoma and related literatures were reviewed.Results A 69-year old woman had unexplained debility and palpitation after exertion for a month.CT showed splenomegaly with multiple occupancy.The resected spleen measured 28 cm×18 cm×10 cm.Histopathological examination demonstrated that the neoplastic cells diffusely infiltrated splenic sinus.The neoplastic cells were characterized by well-defined cell contour,large pleomorphic nuclei,prominent nucleoli,and abundant eosinophilic cytoplasm.Tumor cells with cytoplasmic vacuoles and intense hemophagocytosis were observed.These cells strongly expressed histiocytic markers CD68 and CD163.Immunostaining for LCA,Vim was positive,but negative for CDla,S-100,CD30,CK,CD20,CD3,CD21.Conclusions Immunohistochemistry plays a key role in the diagnosis of primary splenic histiocytic sarcoma.

关 键 词：脾脏 组织细胞肉瘤 临床病理 

分 类 号：R686[医药卫生—骨科学]