乳腺癌术后Stewart-Treves综合征3例临床病理分析  

Lymphangiosarcoma (Stewart-Treves syndrome) in postmastectomy patients

作　　者：崔力方[1] 陈奕至[1] 张继新[1] 王莉[1] 昌红[1] 钟定荣[2] 

机构地区：[1]北京世纪坛医院病理科,北京100038 [2]北京协和医院病理科,北京100730

出　　处：《诊断病理学杂志》2011年第1期31-33,37,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨乳腺癌术后Stewart-Treves综合征的临床病理学特征,提高对该病的诊治水平。方法报道3例乳腺癌术后Stewart-Treves综合征,采用CD34,D2-40,CD31,FⅧ,CK,EMA,vimentin和Ki-67等抗体进行免疫组化染色,并复习文献。结果 3例乳腺癌术后Stewart-Treves综合征患者均以患侧肢体水肿为首发症状,病变皮肤出现红斑或破溃,均有放疗史。镜下表现为浸润性生长的不规则脉管,内衬细胞异型性明显,局部增生成片。免疫组化示肿瘤细胞CD34、CD31、D2-40和vimentin弥漫(+),FⅧ灶性(+);Ki-67约30%(+)。结论乳腺癌术后出现淋巴管肉瘤很少见,与淋巴水肿相关,肿瘤细胞表达淋巴管内皮标记物和出现异型性是诊断关键,患者预后差。Objective To study the clinical pathologic characteristics of Stewart-Treves syndrome in postmastectomy patients.Methods Three cases of Stewart-Treves syndrome in postmastectomy patient were collected,immunohistochemical study for CD34,CD31,FⅧ,D2-40,CK,EMA,vimentin,Ki-67 was performed.Results All the 3 patients presented with lymphedema after mastectomy as the first sign,physical examination revealed multiple raised,pinkish-red papulo-vesicular or ulcer on the field that received radiation therapy.Microscopic examination revealed irregular vessel infiltratively grew,the expression of CD34,CD31,FⅧ,D2-40 and vimentin were detected in the heteromorphic tumor cells.Conclusion Stewart-Treves syndrome in postmastectomy patients is rare.It is related with lymphedema.Heteromorphic tumor cells and immunohistochemical expression are the key points to the diagnosis.

关 键 词：乳腺癌 Stewart-Treves综合征 水肿 

分 类 号：R737.9[医药卫生—肿瘤]