骨原发性平滑肌肉瘤5例临床病理特征  

Clinicopathological features of primary leiomyosarcoma of bone: a report of 5 cases

作　　者：李梅[1] 李传应[1] 刘劲松[2] 李娟[2] 李殿炜[2] 

机构地区：[1]安徽省六安市人民医院病理科,237005 [2]安徽省立医院病理科,合肥230001

出　　处：《临床与实验病理学杂志》2015年第7期769-772,共4页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的：探讨骨原发性平滑肌肉瘤的临床病理学特征、诊断与鉴别诊断、治疗及预后。方法对5例骨原发性平滑肌肉瘤进行组织病理学、免疫表型及影像学分析,并复习相关文献。结果5例骨原发性平滑肌肉瘤发病年龄46～72岁,平均58岁；其中男性2例,女性3例；临床主要症状为疼痛,2例位于干骺端膝关节附近,1例位于股骨上段,1例位于骶骨,另1例位于上颌骨。镜下瘤细胞梭形,少量呈上皮样,瘤细胞均表达vimentin、SMA,其中2例表达desmin,S-100、MyoD1、CD68均阴性。结论骨原发性平滑肌肉瘤较少见,临床症状和影像学表现无特异性,确诊需借助免疫组化标记和电镜检查。Purpose To explore the clinicopathological features, diagnosis and differential diagnosis of primary leiomyosarcoma of bone and to study its therapy and prognosis. Methods Histopathologic features, immunohistochemical stains and iconography of five cases were analyzed and the related literatures were reviewed. Results The patients consisted of two males and three females with ages ran-ging from 46 to 72 years, who average 58 years. Clinically, most cases presented as pain reaction, of which two cases were located a-round the knee joint, one case was in the upper femur, one case was in the sacrum and another was in the upper jaw. Microscopically, tumor cells were composed of spindle shaped cells, with some epitheloid variants. Immunohistochemically, all the tumor cells were pos-itive for smooth muscle actin and vimentin, and the expression of desmin was found in two cases. But S-100 protein, MyoD1 and CD68 were negative. Conclusions Primary leiomyosarcoma of bone is relatively rare, and clinical symptoms and imaging findings are not specific. The diagnosis depends on immunohistochemistry and electron microscopy.

关 键 词：骨平滑肌肉瘤 临床病理 影像学诊断 免疫组织化学 

分 类 号：R738.7[医药卫生—肿瘤]