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目的探讨足部经典型卡波西肉瘤(KS)的临床病理特征、免疫组化及鉴别诊断。方法报道2例发生于足部的经典型卡波西肉瘤的组织形态学和免疫组化特征,结合文献对其临床病理学特征及鉴别诊断进行分析。结果 2例卡波西肉瘤均无HIV感染病史,其中1例发生于足背,1例发生于足底。低倍镜下肿瘤均呈多结节状,结节边界清楚,由增生的梭形细胞组成,伴间质出血;高倍镜下增生的梭形细胞纵横交错排列,梭形细胞被含有红细胞的裂隙样腔隙分割,呈筛孔状或蜂窝状,在梭形细胞胞质内或细胞外可见嗜伊红色透明小体,梭形细胞之间见外渗的红细胞。免疫组化显示瘤细胞CD34、CD31、Fli-1和ERG(+),其中1例HHV-8(+)。结论卡波西肉瘤是一种少见的中间型血管内皮瘤,诊断主要依靠其独特的形态学及免疫表型特征,需注意与梭形细胞血管瘤、卡波西型血管内皮瘤、血管肉瘤和上皮样血管内皮瘤等鉴别。
Objective To investigate the clinicopathological, immunohistochemical and differential diagnosis of classical Kaposi’s sarcoma (KS) in the foot. Methods Two cases of classical Kaposi’s sarcoma, which occurred in the foot, were characterized by histomorphology and immunohistochemistry. The clinical and pathological features and differential diagnosis were analyzed based on the literature. Results Two cases of Kaposi’s sarcoma had no history of HIV infection, of which 1 occurred in the dorsum of the foot and 1 occurred in the plantar. Low magnification tumors showed multiple nodules, nodules clear boundary, by the proliferation of spindle cells, with interstitial hemorrhage; high magnification spindle cells arranged in a crisscross pattern, the spindle cells are containing red blood cell fissure Like the lacunar split, was sieve-like or honeycomb, visible in the cytoplasm of the spindle cells or extracellular eosinophilic red bodies, spindle cells seen extravasated red blood cells. Immunohistochemistry showed tumor cells CD34, CD31, Fli-1 and ERG (+), of which 1 case of HHV-8 (+). Conclusions Kaposi’s sarcoma is an uncommon intermediate hemangioendothelioma. The diagnosis depends mainly on its unique morphological and immunophenotypic characteristics. It is necessary to pay attention to the relationship with the spindle cell hemangioma, Kaposi type hemangioendothelioma, angiosarcoma and Epithelial-like hemangioendothelioma and other identification.