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目的:探讨上皮样血管肉瘤(epithelioid angiosarcoma,EA)的临床病理学特征、诊断及鉴别诊断要点。方法:对1例原发皮下软组织的EA进行组织形态、免疫组化分析。结果:镜下肿瘤细胞弥漫成片,瘤细胞呈上皮样特征,异型性显著。瘤组织之间见相互吻合大小不等的不规则血管腔隙,血管内衬异型肿瘤细胞,可见单个或多个瘤细胞围成管腔,腔内含红细胞。免疫组化示异型肿瘤细胞CD31强阳性,CD34局灶阳性,F8阴性,CKP+/-,CKL+/-。结论:EA是血管肉瘤的一种特殊类型,免疫组化检测有助于确定肿瘤细胞的血管内皮分化。熟悉其形态特征对避免误诊有重要意义。
Objective: To investigate the clinical and pathological features of epithelioid angiosarcoma (EA), and the diagnostic and differential diagnosis points. Methods: One case of primary subcutaneous soft tissue of the EA morphology, immunohistochemical analysis. Results: Microscopically, the tumor cells were diffuse into pieces and the tumor cells showed epithelial-like features with significant atypia. Tumor tissue see mutual agreement between the size of irregular vascular lacunar, vascular lining of heterogeneous tumor cells, showing single or multiple tumor cells surrounded by luminal cavity containing red blood cells. Immunohistochemistry showed that the specific tumor cells CD31 strongly positive, CD34 focal positive, F8 negative, CKP +/-, CKL +/-. Conclusion: EA is a special type of angiosarcoma. Immunohistochemical detection is helpful for the determination of vascular endothelial differentiation in tumor cells. Familiar with its morphological characteristics to avoid misdiagnosis is important.