平滑肌肉瘤的临床病理诊断及鉴别诊断  

Clinical Pathological Diagnosis and Differential Diagnosis of Leiomyosarcoma

作　　者：强欣[1] 初忠侠[1] 孙丽英[2] 钟宏伟[1] 

机构地区：[1]内蒙古民族大学,内蒙古通辽028041 [2]通辽市医院,内蒙古通辽028000

出　　处：《内蒙古民族大学学报（自然科学版）》2004年第2期209-212,共4页Journal of Inner Mongolia Minzu University：Natural Sciences

摘　　要：为进一步探讨平滑肌肉瘤与其它梭形细胞软组织肿瘤的鉴别诊断,选取1970～2002年原病理诊断为平滑肌肉瘤的病历54例,经4位病理医师按标准复查原病理切片,结果一致者30例,有争议者24例.54例分别作免疫组织化学CD117、MSA、Vimentin、a1-AT、S-100蛋白、NF、Desmin、Myoglobin、C-keratin染色.结果54例中维持原诊断仍然是30例,修改诊断24例(44.44%),分别为:恶性间质瘤5例,恶性纤维组织细胞瘤4例,恶性神经鞘瘤4例,单相纤维性滑膜肉瘤4例,纤维肉瘤3例,横纹肌肉瘤2例,平滑肌瘤2例.表明坚实的病理学基础,细致地观察是临床病理正确诊断的关键;合理应用免疫组织化学及特殊染色技术,对平肌肉瘤与其它梭形细胞肿瘤的鉴别诊断是完全必要的.To study further the differential diagnostic between leiomyosarcoma and other spindle cell sarcomas.Fifty-four cases of leiomyosarcomas,which were diagnosed between 1970-2002,were selected. The expression of CD(117),MSA,Vimentin,a1-AT,S-100 protein,neuro-filaments(NF)?desmin?myoglobin and cytokeratin(CK) were selected by means of immunohistochemistry.Among the 54 cases ,30 cases were confirmed to leiomyosarcomas,which were identical with primary diagnoses;24 (44.44%)cases were revised to malignant gastrointestinal stromal tumours(5 cases),malignant fibrous histocytoma(4 cases), malignant nerve sheath tumour(4 cases),monophasic spindl synovial sarcoma(4cases), fibrosarcoma(3cases), rhabdomyosarcoma(2 cases) and leiomyoma(2cases) .Obviovsally study knowledge in pathological morphology and careful observation may be the key point of giving a proper diagnosis, It's necessary to apply reasonable immunohistochemistry and special technoloy in the differential diagnosis between leiomyosarcoma and other spindle cell sarcomas.

关 键 词：平滑肌肉瘤 梭形细胞肿瘤 鉴别 诊断 

分 类 号：R365[医药卫生—病理学]