浅表性平滑肌肉瘤临床病理分析  

Clinicopathological analysis of superficial leiomyosarcoma

作　　者：徐德[1] 程君[2] 周建平[2] 施登超 XU De CHENG Jun ZHOU Jianping SHI Dengchao(Department of Pathology, Affiliated Hospital of Panzhihua University, Panzhihua Sichuan 617000 Department of Basic Medicine, Panzhihua University Medical College, Panzhihua Sichuan 617000 Department of Pathology, Center Hospital of Panzhihua, Panzhihua Sichuan 617000, China)

机构地区：[1]攀枝花学院附属医院病理科,四川攀枝花617000 [2]攀枝花学院基础教研室,四川攀枝花617000 [3]攀枝花市中心医院病理科,四川攀枝花617000

出　　处：《临床与病理杂志》2017年第3期595-599,共5页Journal of Clinical and Pathological Research

摘　　要：目的:探讨浅表性平滑肌肉瘤(superficial leiomyosarcoma,SLMS)的临床病理特点、诊断、鉴别诊断及治疗和预后。方法:回顾性分析13例SLMS的临床病理特征,并复习相关文献讨论。结果:男7例,女6例,平均年龄59岁。肿瘤位于四肢7例,躯干3例,头面部2例,阴囊1例,其中位于真皮的9例,皮下4例。肿瘤直径1~8(平均4.3)cm。局部复发5例,无远处转移病例。镜下:肿瘤呈结节状或弥漫状生长,根据肿瘤细胞不同分化分为三型:中分化(最多见,9例)、高分化和低分化型(较少,各2例)。免疫组织化学:肿瘤细胞desmin,MSA,a-SMA和h-caldesmon阳性。结论:SLMS多发生于中老年人,预后较好,易发生局部复发,极少发生远处转移。治疗采用局部扩大切除。Objective：To investigate the clinical and pathological features,diagnosis,differential diagnosis,treatment and prognosis of superficial leiomyosarcoma（SLMS）.Methods：We retrospectively analyzed the clinicopathological features of 13 cases of SLMS,and reviewed the related literature.Results：Seven male cases and 6 female cases were collected,the average age of all patients was 59 years old.Tumor lesions were located in the extremities（7 cases）,trunk（3 cases）,head and face（2 cases） and scrotum（1 cases） respectively,and 9 cases of them were located in the dermis,and 4 cases were under the skin.The average diameter of all tumors was 1–8 cm,with an average of 4.3 cm.Local recurrences were investigated in 5 cases,and no distant metastasis was found.Microscopic observation revealed that the tumors were nodular or diffuse,of which,9 cases of moderately differentiated tumor cells,2 cases of high differentiated and 2 cases of low differentiated tumor cells were observed.Immunohistochemical staining showed that desmin,MSA,h-caldesmon and a-SMA were positive in these tumor cells.Conclusion：Superficial leiomyosarcoma often occurs in the elderly.The prognosis of SLMS is good.The local recurrence rate of SLMS was high,but there was almost no distant metastasis.

关 键 词：浅表性平滑肌肉瘤 临床病理 诊断 鉴别诊断 

分 类 号：R738.6[医药卫生—肿瘤]