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目的探讨上皮样肉瘤的临床病理学特征和鉴别诊断。方法回顾性分析5例上皮样肉瘤的临床表现、组织学特点和免疫组化,并结合文献探讨上皮样肉瘤的临床病理特点、诊断与鉴别诊断。结果 5例均为手术切除标本,其中2例为截肢标本。男性4例,女性1例,男性多见。平均年龄31.4岁。镜下观察肿瘤由梭形和上皮样的细胞组成,两种细胞在形态上有移行。免疫组化显示上皮和间叶组织双向分化,5例CK、EMA和vimentin均(+),desmin和HMB45均(-)。2例CD34(+),2例SMA(+)。结论上皮样肉瘤是一种较罕见恶性肿瘤,由于其临床表现无特异性,确诊需依赖于病理组织学和免疫组化染色,同时与形态学上同样具有上皮样或者横纹肌样细胞特点的其他疾病进行鉴别诊断。
Objective To investigate the clinicopathological characteristics and differential diagnosis of epithelioid sarcoma. Methods The clinical manifestations, histological features and immunohistochemistry of 5 cases of epithelioid sarcoma were retrospectively analyzed. The clinical and pathological features, diagnosis and differential diagnosis of epithelioid sarcoma were also discussed. Results All the 5 cases were resected specimens, of which 2 were amputation specimens. 4 males and 1 females, more common in males. The average age is 31.4 years old. Microscopically, the tumor consisted of fusiform and epithelial cells, and the two cells migrated in morphology. Immunohistochemistry showed that the epithelial and mesenchymal tissues differentiated bidirectionally. Five cases of CK, EMA and vimentin (+), both desmin and HMB45 (-). 2 cases of CD34 (+), 2 cases of SMA (+). Conclusions Epithelioid sarcoma is a rare malignant tumor. Because of its non-specific clinical manifestations, the diagnosis depends on histopathological and immunohistochemical staining. At the same time, other diseases that are morphologically similar to epithelial-like or striated muscle-like cells Differential diagnosis.