胃肠转移性未分化多形性肉瘤1例及文献复习  

Undifferentiated pleomorphic sarcoma with metastasis to the gastrointestinal tract:report of a case and literature review

作　　者：梁乐[1] 遆红娟[1] 刘铭[2] 付静[1] 姜北 Liang Le;Ti Hongjuan;Liu Ming;Fu Jing;Jiang Bei(Department of Pathology,Beijing Haidian Hospital/Haidian Section of Peking University Third Hospital,Beijing 100080,China;Department of general surgery,Beijing Haidian Hospital/Haidian Section of Peking University Third Hospital,Beijing 100080,China)

机构地区：[1]北京市海淀医院/北京大学第三医院海淀院区病理科,北京100080 [2]北京市海淀医院/北京大学第三医院海淀院区普通外科,北京100080

出　　处：《中国组织化学与细胞化学杂志》2024年第4期370-374,共5页Chinese Journal of Histochemistry and Cytochemistry

摘　　要：目的探讨胃肠转移性未分化多形性肉瘤的临床病理特征、鉴别诊断、治疗及预后,提高诊断水平。方法回顾性分析1例右下肢未分化多形性肉瘤转移至胃和十二指肠病例的临床病理特征及免疫表型,并复习相关文献。结果胃镜活检显示胃及十二指肠粘膜固有层分化差的梭形细胞恶性肿瘤,呈不规则束状排列,可见多形性、奇异型肿瘤细胞和多核瘤巨细胞。免疫组织化学染色显示vimentin阳性,Ki-67阳性指数约70%。结论胃肠转移性未分化多形性肉瘤非常罕见,本例旨在提高病理医师对此罕见转移性肿瘤认识的敏锐性,需要结合临床病史、采用广泛的免疫组织化学指标做排除性诊断,避免误诊。Objective To investigate the clinicopathological features,differential diagnosis,treatment,and prognosis of gastrointestinal metastatic undifferentiated pleomorphic sarcoma,aiming to improve diagnostic capabilities.Methods A retrospective analysis was conducted on a case of undifferentiated pleomorphic sarcoma in the right lower limb metastasizing to the stomach and duodenum,focusing on its clinicopathological features and immunophenotype,along with a review of relevant literature.Results Endoscopic biopsy showed a poorly differentiated spindle cell malignancy in the lamina propria of the gastric and duodenal mucosa arranging in irregular bundles with pleomorphic and bizarre tumor cells and multinucleated tumor giant cells.Immunohistochemical staining showed vimentin positivity and the Ki-67 positivity index was about 70%.Conclusion Gastrointestinal metastatic undifferentiated pleomorphic sarcoma is very rare.This case aims to improve the pathologist’s sensitivity to this rare metastatic tumor.It is necessary to combine clinical history and use a wide range of immunohistochemical indicators to make an exclusionary diagnosis to avoid misdiagnosis.

关 键 词：肉瘤 胃肿瘤 转移性肿瘤 免疫组织化学表型 

分 类 号：R365[医药卫生—病理学]