伴脑膜上皮样漩涡和骨化生去分化脂肪肉瘤的临床病理分析

发布时间：2018-01-19 19:10

本文关键词： 脂肪肉瘤去分化脂肪肉瘤免疫组织化学　出处：《临床与实验病理学杂志》2017年07期 　论文类型：期刊论文

【摘要】：目的探讨伴脑膜上皮样漩涡和骨化生去分化脂肪肉瘤的临床特点、组织学特征、免疫表型、遗传学特点、诊断及鉴别诊断。方法回顾性分析1例伴脑膜上皮样漩涡和骨化生去分化脂肪肉瘤的临床资料、组织学特征、免疫表型和遗传学特点,并复习相关文献。结果伴脑膜上皮样漩涡和骨化生去分化脂肪肉瘤界限清楚,由硬化性脂肪肉瘤、脑膜上皮样漩涡状、骨化生和脂肪瘤样脂肪肉瘤等成分构成,脑膜上皮样漩涡状成分由上皮样细胞或梭形细胞呈漩涡状排列构成,与其它成分界限清楚。免疫表型:肿瘤细胞vimentin、MDM2、CDK4、p16、CD10和CD56均呈弥漫强阳性;CK、EMA、CD34、Caldesmon、PGP9.5和PR均呈阴性;S-100、Ki-67和p53在不同成分中表达不一致。遗传学检测显示MDM2扩增。结论伴脑膜上皮样漩涡和骨化生去分化脂肪肉瘤属于罕见的去分化脂肪肉瘤,脑膜上皮样漩涡状成分免疫表型和遗传学特点与其它脂肪肉瘤成分大致相同,提示漩涡状结构为去分化脂肪肉瘤的去分化成分,结合组织学特征、免疫表型和遗传学特点,可与其它具有漩涡状结构的肿瘤鉴别。
[Abstract]:Objective to investigate the clinical features of meningeal epithelioid swirls and osseous metaplasia of dedifferentiated liposarcoma, histological features, immunophenotype and genetic features, diagnosis and differential diagnosis. Methods Retrospective analysis of clinical data of 1 cases with meningeal epithelioid swirls and osseous metaplasia of dedifferentiated liposarcoma, histological features, immunophenotype and genetic characteristics, and review the results of the related literature. Meningeal epithelioid swirls and osseous metaplasia dedifferentiated liposarcoma boundary clear by sclerosing liposarcoma, meningeal epithelioid whirlpool, ossification and lipoma like liposarcoma and other components, meningothelial like swirling component composed of epithelioid cells or spindle cells arranged in whorls, and other components of immunophenotype with clear boundary.: vimentin tumor cells MDM2, CDK4, p16, CD10 and CD56 showed diffuse strong positive; CK, EMA, CD34, Caldesmon, PGP9.5 and PR were negative; S-100, Ki- 67 and the expression of p53 was different in different components. Genetic testing showed MDM2 amplification. Conclusion meningeal epithelioid swirls and osseous metaplasia dedifferentiated liposarcoma is rare dedifferentiated liposarcoma, meningeal epithelioid swirling component of the immune phenotype and genetic characteristics of fat meat and other ingredients of roughly the same, suggesting that vortex like structure to dedifferentiated liposarcoma the differentiation of ingredients, combined with histological features, immunophenotype and genetic features, with tumors swirling structure and other.

【作者单位】：广州医科大学附属第三医院病理科;
【分类号】：R738.6
【正文快照】： 去分化脂肪肉瘤是由分化性成分和去分化成分构成的脂肪肉瘤,分化性成分包括脂肪瘤样脂肪肉瘤、硬化性脂肪肉瘤、炎性脂肪肉瘤和梭形细胞脂肪肉瘤,去分化成分指形态类似非脂肪源性的肉瘤,包括多型性未分化肉瘤、纤维肉瘤、黏液纤维肉瘤、血管肉瘤、横纹肌肉瘤、平滑肌肉瘤和骨

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