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目的探讨骨外黏液样软骨肉瘤的临床病理学特征。方法对2例骨外黏液样软骨肉瘤进行光镜观察及免疫组化染色标记,并通过相关文献复习,对病理诊断及鉴别诊断等指标进行分析。结果1例发生于足底,1例发生于乳腺。光镜下肿瘤呈分叶状,边界清。细胞为圆形及短梭形,成束状排列于黏液样基质中,局部可见围血管形成玫瑰花结样结构。部分肿瘤细胞异型性明显。免疫表型:vimentin、NSE、Syn均呈阳性;例1EMA灶性阳性,例2阴性;S-100蛋白、CgA及CK均阴性。结论骨外黏液样软骨肉瘤为罕见的软组织恶性肿瘤,具特异性的组织病理学特点。主要发生于四肢,少数可发生于实质器官,至今未有乳腺原发病例报道。部分肿瘤细胞可发生间变导致诊断困难,须与脊索瘤、骨内软骨肉瘤、化生性癌及黏液性肿瘤等鉴别。
Objective To investigate the clinicopathological features of extraosseous mucoid chondrosarcoma. Methods Two cases of extraosseous mucoid chondrosarcoma were stained with light microscopy and immunohistochemistry, and the related literature was reviewed to analyze the pathological diagnosis and differential diagnosis. Results 1 case occurred in the plantar, 1 case occurred in the breast. Light microscope tumor lobulated, clear boundary. Cells were round and short fusiform, arranged in a bundle of mucin-like matrix, the local visible vascularized rosettes structure. Some tumor cells atypia obvious. Immunophenotype: vimentin, NSE, Syn were positive; Example 1EMA foci positive, 2 negative; S-100 protein, CgA and CK were negative. Conclusion Extraosseous mucoid chondrosarcoma is a rare malignant tumor of soft tissue with specific histopathological features. Occurs mainly in the limbs, a few may occur in the real organs, so far no case of primary breast cancer reported. Some of the tumor cells may lead to the formation of anaplastic diagnosis, and chordoma, intraosseous chondrosarcoma, metaplastic cancer and mucinous tumors and other identification.