CAJ | 학술논문

目的探讨指状树突细胞肉瘤/肿瘤(IDCS)的病理特征、诊断及鉴别诊断.方法分析3例IDCS的临床表现,对标本进行病理形态和免疫组织化学(EnVision法)染色观察.结果大体检查肿瘤呈灰白、灰黄色,质实.1例发生于左肺,1例原发于脾脏伴全身淋巴结累及,1例发生于淋巴结.光镜下肿瘤组织呈边界不甚清楚的巢片状,部分呈束状、旋涡状排列,周边较多淋巴细胞、浆细胞浸润.肿瘤细胞呈卵圆形或梭形,胞质透亮或轻度嗜酸性,核卵圆形,呈空泡状,可见不明显的小核仁,部分见有核沟.免疫组织化学肿瘤细胞表达S-100蛋白.结论 IDCS是一种罕见的组织细胞和树突细胞恶性肿瘤,有一定的病理学特征.应与滤泡树突细胞肉瘤、炎性假瘤、朗格汉斯细胞组织细胞增生症、恶性黑色素瘤、未分化癌及间变性大细胞淋巴瘤等鉴别.免疫组织化学S-100蛋白等标记对鉴别诊断有帮助.
목적 탐토지상수돌세포육류/종류(IDCS)적병리특정、진단급감별진단.방법 분석3례IDCS적림상표현,대표본진행병리형태화면역조직화학(EnVision법)염색관찰.결과 대체검사종류정회백、회황색,질실.1례발생우좌폐,1례원발우비장반전신림파결루급,1례발생우림파결.광경하종류조직정변계불심청초적소편상,부분정속상、선와상배렬,주변교다림파세포、장세포침윤.종류세포정란원형혹사형,포질투량혹경도기산성,핵란원형,정공포상,가견불명현적소핵인,부분견유핵구.면역조직화학종류세포표체S-100단백.결론 IDCS시일충한견적조직세포화수돌세포악성종류,유일정적병이학특정.응여려포수돌세포육류、염성가류、랑격한사세포조직세포증생증、악성흑색소류、미분화암급간변성대세포림파류등감별.면역조직화학S-100단백등표기대감별진단유방조.
Objective To study the pathologic features, diagnosis and differential diagnosis of interdigitating dendritic cell sarcoma (IDCS). Methods The clinical findings, morphologic features and immunophenotype of 3 cases of IDCS were investigated. Results (;ross examination showed that IDCS had a greyish-white to greyish-yellow cut surface. The site of occurrence included lung, spleen (with lymph node metastasis) and lymph node. Histologically, the tumor cells were arranged in nests, fascicles and whorls, with intimate admixture of many lymphocytes and plasma cells. They were oval to spindle in shape and contained pale eosinophilic cytoplasm, oval and sometimes grooved nuclei, small distinct nucleoli and ill-defined cell borders. Immunohistochemical study showed that the tumor cells expressed S-100 protein.Conclusions IDCS is a rare type of histiocytic and dendritic cell malignancy with distinctive morpholngic findings. It needs to be distinguished from follicular dendritic cell sarcoma, inflammatory pseudotumor, Langerhans' cell histiocytosis, malignant melanoma, undifferentiated carcinoma and anaplastic large cell lymphoma. Immunohistochemical staining for S-100 protein is helpful in confirming the diagnosis.