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目的探讨心横纹肌肉瘤的临床病理学特征及诊断、鉴别诊断要点。方法对1例心横纹肌肉瘤进行临床病理分析及免疫组化研究,并复习相关文献。结果镜下见瘤细胞弥漫生长,疏密不等,部分区域有黏液样基质,部分区域为红染基质。瘤细胞大部分为大圆形、短梭形,核深染,不均匀成块状。部分细胞分化较好,核分裂象易见,可见少量瘤巨细胞。肿瘤组织结节样突向心肌内。免疫组化:PAS和CD68(+)、desmin、vimentin、CD68和CD117(),MyoD1(),CK、PCNA68%(+),myoglobin、S-100、p53和Ki-67(-)。结论原发性心横纹肌肉瘤罕见,恶性程度高、侵袭性强,组织形态学及临床表现有较大差异,免疫组化检测能增加诊断的正确性。
Objective To investigate the clinical and pathological features of cardiac rhabdomyosarcoma and its diagnostic and differential diagnosis. Methods One case of cardiac rhabdomyosarcoma was studied by clinicopathological analysis and immunohistochemistry, and the related literatures were reviewed. The results of microscopic see tumor cells diffuse growth, density range, some areas of myxoid-like matrix, part of the area for the red-dye matrix. Most of the tumor cells are large round, short fusiform, nuclear stained, uneven into massive. Part of the cell differentiation is good, mitotic easy to see, we can see a small amount of tumor giant cells. Tumor-like nodular protruding into the myocardium. Immunohistochemistry: PAS and CD68 (+), desmin, vimentin, CD68 and CD117 (), MyoD1 (), CK, PCNA68% (+), myoglobin, S-100, p53 and Ki-67 (-). Conclusions The primary cardiac rhabdomyosarcoma is rare, highly malignant, highly aggressive, histomorphological and clinical manifestations are quite different, immunohistochemical detection can increase the diagnostic accuracy.