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目的探讨心包滑膜肉瘤的临床病理学特征及其鉴别诊断,提高对该病的认识和诊治水平。方法对1例心包滑膜肉瘤进行光镜观察、免疫组化染色和荧光原位杂交(FISH)检测,并结合文献分析讨论。结果肿瘤由单一的梭形细胞组成,呈交织的束状,向上皮样细胞分化。免疫组化:calponin(+),p53和vimentin(+),bcl-2和EMA散在(+)。FISH检测显示18号染色体基因位点断裂及易位。结论心包单相纤维型滑膜肉瘤诊断较为困难,容易误诊,在掌握组织学特征和临床病史的同时,必须结合免疫组化及分子生物学检测综合分析,才能作出正确诊断。
Objective To investigate the clinicopathological characteristics and differential diagnosis of pericardial synovial sarcoma and to improve the understanding and diagnosis and treatment of the disease. Methods One case of pericardial synovial sarcoma was observed by light microscopy, immunohistochemistry and FISH, and analyzed by literature. Results The tumor consisted of a single spindle cell with interlaced bundles that differentiated into epithelial-like cells. Immunohistochemistry: calponin (+), p53 and vimentin (+), bcl-2 and EMA scattered (+). FISH test showed that the chromosome 18 gene locus rupture and translocation. Conclusions Pericardial single-phase fibromuscular synovial sarcoma is more difficult to diagnose, easily misdiagnosed. While grasping histological features and clinical history, it must be combined with immunohistochemistry and molecular biology comprehensive analysis to make the correct diagnosis.