發(fā)布時(shí)間：2018-06-18 01:30

  本文選題：軟組織腫瘤 + 黏液型滑膜肉瘤��； 參考：《臨床與實(shí)驗(yàn)病理學(xué)雜志》2017年02期

【摘要】：目的探討?zhàn)ひ盒突と饬?myxoid synovial sarcoma,MSS)的臨床病理學(xué)特征、診斷及鑒別診斷。方法對(duì)2例MSS進(jìn)行組織形態(tài)學(xué)觀察、免疫組化染色、分子病理學(xué)檢測(cè)并復(fù)習(xí)相關(guān)文獻(xiàn)。結(jié)果例1男性,例2女性。年齡分別為71歲及15歲。例1腫物位于左下腹,例2腫物位于左側(cè)額顳葉。鏡檢:例1低倍鏡下腫瘤呈結(jié)節(jié)樣,結(jié)節(jié)內(nèi)腫瘤由細(xì)胞疏松區(qū)與致密區(qū)組成。疏松區(qū)細(xì)胞呈漩渦狀、束狀、片狀排列,間質(zhì)見大量黏液樣基質(zhì),細(xì)胞異型性明顯。致密區(qū)細(xì)胞豐富,瘤細(xì)胞呈束狀、魚骨樣排列。例2腫瘤由細(xì)胞疏松區(qū)及致密區(qū)組成,兩者間相互移行。疏松區(qū)細(xì)胞呈疏松網(wǎng)狀、片狀排列,間質(zhì)見大量黏液樣基質(zhì)。部分區(qū)域見少量上皮樣細(xì)胞,呈小簇狀分布。致密區(qū)細(xì)胞豐富,呈束狀、片狀排列。未侵犯腦組織。免疫表型:例1,BCL-2、vimentin陽性,α-SMA和EMA部分細(xì)胞陽性,CD34、CD57、S-100、CD117、PLAP均陰性。例2,BCL-2陽性,Myo D1胞質(zhì)陽性,GFAP、Olig-2、EMA、Syn、CD99、Cg A、S-100、Myogenin、STAT6、CD34、desmin、α-SMA均陰性。分子病理學(xué)檢測(cè):2例均檢測(cè)到SYT-SSX融合基因。結(jié)論 MSS是一種罕見的軟組織惡性腫瘤,確診主要依靠分子病理學(xué)檢測(cè),臨床與病理均需與黏液型纖維肉瘤、孤立性纖維性腫瘤等鑒別。治療以手術(shù)切除聯(lián)合放療為主,預(yù)后不良。
[Abstract]:Objective to investigate the clinicopathological features, diagnosis and differential diagnosis of myxoid synovial sarcomas. Methods two cases of MSS were observed by histomorphology, immunohistochemical staining, molecular pathology and literature review. Results case 1 male, case 2 female. The ages were 71 and 15 respectively. Case 1 was located in the left lower abdomen and case 2 was located in the left frontotemporal lobe. Case 1 was nodular under low power microscope. The tumor in the nodules was composed of loose and dense areas. In the loose area, the cells were whirlpool, bundles and flakes. A large number of myxoid substrates were found in the interstitial cells, and the heterogeneity of the cells was obvious. Dense area is rich in cells, tumor cells are bundles, fish bone-like arrangement. In case 2, the tumor was composed of loose area and compact area. The cells in the loose area were loose reticular, flaky, and a large number of mucus-like matrix were found in the interstitial. A small number of epithelioid cells were found in some areas and distributed in small clusters. Dense area cells are abundant, bunchy, flaky arrangement. No invasion of brain tissue. Immunophenotype: in case 1, BCL-2 vimentin was positive, and some of the positive cells of 偽 -SMA and EMA were negative for CD34, CD57, S-100, CD117, plap. In case 2, BCL-2 was positive and Myo D1 cytoplasm was positive for GFAPL Olig-2EMAA. The expression of CD 9C 9N C g Agna S-100 and Myogenin statin 6 CD34 desminin, 偽 -SMA were negative. SYT-SSX fusion gene was detected in 2 cases by molecular pathology. Conclusion MSS is a rare malignant tumor of soft tissue. The diagnosis of MSS mainly depends on molecular pathological examination. The clinical and pathological diagnosis should be distinguished from myxofibrosarcoma and solitary fibrous tumor. Surgical resection combined with radiotherapy was the main treatment with poor prognosis.
【作者單位】： 福建省晉江市醫(yī)院病理科;福建省立醫(yī)院病理科;福建省龍巖市第二醫(yī)院病理科;
【分類號(hào)】：R738.5

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