黏液纤维肉瘤临床病理观察  

Clinicopathological observation of myxofibrosarcoma

作　　者：何珏[1] 王天科[2] 韩巧秀[1] 

机构地区：[1]赣南医学院病理学教研室,江西赣州341000 [2]温州医科大学附属慈溪医院病理科,浙江宁波315300

出　　处：《中华肿瘤防治杂志》2015年第15期1235-1239,共5页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的探讨黏液纤维肉瘤（myxofibrosarcoma，MFS）的临床、病理及免疫组化特征。方法收集2006—01—01—2013—12—31具有完整临床资料的11例MFS存档组织蜡块，其中赣南医学院第一附属医院5例，温州医科大学附属慈溪医院4例，赣州市南康区人民医院会诊病例2例。常规病理切片及免疫组化标记，光学显微镜观察，综合全部临床及病理资料总结分析。结果在11例MFS中，10例发生在61--82岁老年群体，1例发生在有骨折钢板植入史的29岁男性。肿瘤直径2．5～12cm。光镜下肿瘤呈浸润性，具有黏液样背景，以梭形细胞为主，可见星芒状、圆形、空泡样假脂肪母细胞及多核巨细胞，偶见上皮样细胞；瘤细胞胞质淡嗜酸性，高级别肿瘤异型性较大，常见核分裂；间质多见曲线型血管。免疫组化示，11例Vim（＋）、SMA局灶（＋），7例CD34（＋），5例p53（-t-），5例Ki-67表达指数〉10％。病理确诊10例MFS，1例上皮样MFS；病理分级，1级6例，2级3例，3级2例；TNM分期，ⅠA期4例，ⅠB期2例，ⅡA期2例，ⅡB期3例。随访12～60个月，4例生存，4例复发，1例肿瘤多器官播散死亡，2例自然死亡。结论MFS是多发生于老年群体的少见软组织恶性肿瘤，具有独特的病理形态特征，表达纤雏／肌纤维母细胞免疫表型，准确及时的病理诊断可为临床有效治疗提供科学依据。OBJECTIVE To investigate the clinicopathologic and immunohistoch-emical features of Myxofibrosarcoma （MFS）. METHODS The clinical data and tissue paraffin of 11 cases MFS from January lst,2006 to December 31st,2013 were collected（5 cases from First Affiliated Hospital of Gannan Medical College, 4 cases from Affiliated Cixi Hospital of Wenzhou Medical University, 2 cases from consultation case of the Nankang District People＇s Hospital of Ganzhou City）, and the conven- tional pathology, immunohistochemical and observation by light microscope as well as the clinical and pathological data were ana- lyzed comprehensively. RESULTS In 11 cases of MFS,10 cases occurred in 61--82 years old,1 male case occurred in 29 year old with the fracture history of steel plate implant. The tumor diameters ranged from 2.5 cm to 12 cm,Optical microscope tumors were invasive, with myxoid backgroun; mainly with spindle cell, visible stellate shaped, circular, vesicular similar to the fat cells and multinucleated giant cells, occasionally epithelioid cells. Tumor cells were slightly eosinophilic. High-grade sarcomas atypia was quite large and easy to find nuclear division. Curve blood vessels can be observed in mesenchyme very often. Immunohistochemistry：Vimentin was positive in 11 cases,focal positive for SMA;The CD34 was positive in 7 cases and positive for p53 in 5 cases. 5 cases were Ki-67 expression index 〉 10%. Pathological diagnosis： 10 cases of MFS, 1 cases of epithelioid MFS; Pathological grading： Grade 1 in with 6 cases,grade 2 with 3 eases,grade 3 with 2 eases; TNM stage： 4 eases with IA,2 eases with stage IB, 2 cases with stage llA,3 cases with stage liB;The follow-up of 12-60 months,4 cases were still living and in good health,4 cases of recurrence, 1 eases died of tumor multiorgan disseminate, 2 eases died of natural causes. CONCLUSION Myxofibrosarcoma is a rare soft tissue malignant tumors occur in the elderly, with distinct pathological features, the expression of fibroblast/myofibroblastic immunophenoty

关 键 词：软组织肿瘤 黏液纤维肉瘤 免疫组织化学 临床病理 

分 类 号：R738.6[医药卫生—肿瘤]