附睾横纹肌肉瘤的临床病理学特征并文献复习  

The clinical pathological features of rhabdomyosarcoma of the epididymis and literature review

作　　者：廖谦和 安慧敏 陈志永 Liao Qianhe;An Huimin;Chen Zhiyong(Department of Pathology,Shuyang People′s Hospital of Jiangsu,Shuyang 223600,China;Department of Pathology,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,Hangzhou 310016,China;Department of Urology,Shuyang People′s Hospital of Jiangsu,Shuyang 223600,China)

机构地区：[1]江苏省沭阳人民医院病理科,223600 [2]浙江大学医学院附属邵逸夫医院病理科,杭州310016 [3]江苏省沭阳人民医院泌尿外科,223600

出　　处：《中华诊断学电子杂志》2020年第4期270-274,共5页Chinese Journal of Diagnostics(Electronic Edition)

摘　　要：目的探讨附睾横纹肌肉瘤的临床病理学特征。方法选择2011年1月至2019年12月江苏省沭阳人民医院泌尿外科收治的3例附睾横纹肌肉瘤患者,应用常规病理检查和免疫组织化学方法,分析附睾横纹肌肉瘤的临床病理学特征。结果3例附睾横纹肌肉瘤患者的年龄分别为10岁、23岁和25岁,病程分别为1个月、2个月和4个月。左侧附睾1例,右侧附睾2例,均为单发性病灶,临床以阴囊肿块并进行性增大为主要症状。B超和磁共振成像(MRI)检查均发现附睾占位性病变,术后病理诊断为附睾横纹肌肉瘤,其中2例为腺泡状横纹肌肉瘤,1例为胚胎性横纹肌肉瘤。病理组织学检查显示肿瘤由原始间叶细胞和不同分化的横纹肌母细胞组成,免疫组织化学显示肌细胞生成素(myogenin)、肌调节蛋白(MyoD1)、波形蛋白(vimentin)和结蛋白(desmin)阳性,神经元特异性稀醇化酶(NSE)、S-100蛋白、肌动蛋白(actin)、平滑肌肌动蛋白(SMA)、内皮细胞标记物(CD34)、尤文氏肉瘤标记物(CD99)和广谱细胞角蛋白(CKpan)阴性。结论附睾横纹肌肉瘤是一种比较少见的恶性肿瘤,早期诊断和规范治疗可获得较好的预后。Objective To explore the clinical and pathological features of rhabdomyosarcoma of the epididymis.Methods Three cases of epididymal rhabdomyosarcoma admitted to Shuyang People′s Hospital of Jiangsu from January 2011 to December 2019 were selected.The clinical and pathological features of the 3 cases were studied by pathological examination and immunhistochemical staining.Results The 3 patients with rhabdomyosarcoma of the epididymis were aged 10 years,23 years and 25 years,respectively.The course of disease was 1 month,2 months and 4 months,respectively.Among them,1 case of left epididymis and 2 cases of right epididymis,and all were single nidus.The main clinical symptom was a scrotal mass with progressive enlargement.Both ultrasonography and MRI examination showed epididymal space occupying lesions.Postoperative pathology diagnosed epididymal rhabdomyosarcoma,including 2 cases of alveolar rhabdomyosarcoma and 1 case of embryonal rhabdomyosarcoma.Microscopically,the tumor consisted of primitive mesenchymal cells and differentiated rhabdomyocytes.Immunohistochemically,the tumor cells were positive for myogenin,myogenic differentiation(MyoD1),vimentin and desmin,but negative for neuron specific enolase(NSE),S-100,actin,smooth muscle actin(SMA),CD34,CD99 and cytokeratinpan(CKpan).Conclusion Rhabdomyosarcoma of epididymis is a rare malignant tumour,and early diagnosis and standard treatment can achieve a good prognosis.

关 键 词：附睾肿瘤 横纹肌肉瘤 诊断 病理学 

分 类 号：R737.21[医药卫生—肿瘤]