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目的分析左心房二尖瓣前瓣神经鞘瘤局部恶变的临床病理特征及诊断依据。方法对1例发生于左房二尖瓣前瓣的肿瘤进行组织形态学和免疫组化研究,结合文献讨论其病理组织学特征。结果肿瘤呈典型的神经鞘瘤形态,局部区域细胞密集,瘤细胞有异型性、核增大,有明显的大红核仁,核分裂象活跃;免疫组化示S-100和vimentin(+),EMA局灶(+),Ki-67为10%～25%。结论原发于心脏的神经鞘瘤罕见,且伴局部恶性变者更少见,诊断主要依靠典型的组织形态学改变和免疫组化。
Objective To analyze the clinicopathological features and diagnosis of local degeneration of schwannoma of the left atrial mitral valve. Methods Tumor histomorphometry and immunohistochemistry were performed in 1 case of anterior mitral valve flap of the left atrium. The histopathological features were discussed in the literature. Results The tumors showed typical schwannoma morphology. The local areas were densely populated. The tumor cells were atypia. The nuclei were enlarged, with obvious red nucleolus. The mitotic figures were active. Immunohistochemistry showed that the S-100 and vimentin (+), EMA Focal (+), Ki-67 was 10% to 25%. Conclusions The primary schwannoma in the heart is rare, and the patients with locally malignant transformation are rarer. The diagnosis mainly relies on typical histopathological changes and immunohistochemistry.