一例表浅软组织骨外尤因肉瘤临床病理观察及鉴别诊断  

A Case of Superficial Soft Tissue Extraosseous Ewing Sarcoma:Clinicopathological Observation and Differential Diagnosis

作　　者：徐金平 陈云昭 惠奕 史盼成 苏玲[1] XU Jinping;CHEN Yunzhao;HUI Yi;SHI Pancheng;SU Ling(People's Hospital of Suzhou High-tech Zone,Suzhou,Jiangsu 215000,China)

机构地区：[1]苏州高新区人民医院,江苏苏州215000

出　　处：《大医生》2019年第16期172-174,共3页Doctor

摘　　要：本文对1例E-EWS行免疫组织化学和FISH检测并复习相关文献。14岁男性,左腋下包块一年;镜下肿瘤细胞形态较幼稚,由大小一致的小圆细胞或卵圆细胞构成,胞浆较少,细胞核形态较规则,部分区胞浆透亮,病理性核分裂像易见,并见大片凝固性坏死,肿瘤细胞部分区菊花团样及乳头状结构。免疫表型:肿瘤细胞区域CD99、FlI-1、Syn、Vimentin、Bcl-2、CD117、Ki-67均为阳性,CK、CK20、GCDFP15、P63、HMB45、S-100、CgA、CD56、LCA、CD34、EMA、CK18、CD30、Calponin、AFP、PLAP、AE1/AE3、Desmin均为阴性;FISH检测:存在EWSR1基因断裂(>50%肿瘤细胞内可见红绿分离信号)。E-EWS需结合组织形态学、免疫组化及分子病理综合诊断。表浅型E-EWS早期易被发现,综合治疗后预后相对较好。A case of E-EWS was examined by immunohistochemistry and FISH,and the related literatures were reviewed.A left underarm mass was found in a 14-year-old male for 1 year.Under the microscope,the tumor cells were immature and consist of small round cells or oval cells of the same size,with less cytoplasm and regular nuclear morphology.Some areas of cytoplasm are clear,pathological mitotic images were easy to be seen,and large areas of coagulation necrosis were seen.Some areas of tumor cells were chrysanthemum-like and papillary structures.Immunophenotype:CD99,FlI-1,Syn,Vimentin,Bcl-2,CD117,Ki-67 were all positive in tumor cell region,CK,CK20,GCDFP15,P63,HMB45,S-100,CgA,CD56,LCA,CD34,EMA,CK18,CD30,Calponin,AFP,PLAP,AE1/AE3,Desmin was negative;Fish detection:There was a break in EWSR1 gene(more than 50%of tumor cells had red-green signal).The comprehensive diagnosis of E-EWS should be combined with histomorphology,immunohistochemistry and molecular pathology.Superficial E-EWS is easy to be detected in the early stage,and the prognosis is relatively good after comprehensive treatment.

关 键 词：骨外尤文氏肉瘤 分子病理学 

分 类 号：R73[医药卫生—肿瘤]