CAJ | 학술논문

目的探讨输卵管肉瘤样癌的病理形态学及免疫组织化学表型,提高对该病的认识和诊治水平.方法输卵管肉瘤样癌1例,光镜下观察其形态特征,应用免疫组化检测肉瘤样癌CK、EMA、S-100蛋白、Desmin、SMA、Leu-7、CD68、actin及Vimentin等的表达情况,并结合文献探讨该肿瘤的病理学表现及临床生物学行为.结果光镜下肉瘤样成分与癌成分共存.瘤体多以肉瘤样成分为主,肉瘤样组织中未见明确的骨、软骨、横纹肌肉瘤等异源成分.免疫组化检测表明:CK7、EMA和Vimentin表达均呈强阳性;S-100蛋白、SMA、Leu-7、CD68和actin表达呈部分阳性.结论该病临床表现缺乏特异性症状,术前诊断困难;B超、CT、MRI对分期有帮助.确诊依靠病理检查及免疫组化检测.输卵管肉瘤样癌极为少见,该肿瘤早期就可发生血行转移,预后极差,早期发现是改善预后的关键.
목적 탐토수란관육류양암적병리형태학급면역조직화학표형,제고대해병적인식화진치수평.방법 수란관육류양암1례,광경하관찰기형태특정,응용면역조화검측육류양암CK、EMA、S-100단백、Desmin、SMA、Leu-7、CD68、actin급Vimentin등적표체정황,병결합문헌탐토해종류적병이학표현급림상생물학행위.결과 광경하육류양성분여암성분공존.류체다이육류양성분위주,육류양조직중미견명학적골、연골、횡문기육류등이원성분.면역조화검측표명:CK7、EMA화Vimentin표체균정강양성;S-100단백、SMA、Leu-7、CD68화actin표체정부분양성.결론 해병림상표현결핍특이성증상,술전진단곤난;B초、CT、MRI대분기유방조.학진의고병리검사급면역조화검측.수란관육류양암겁위소견,해종류조기취가발생혈행전이,예후겁차,조기발현시개선예후적관건.
Objective To investigate the pathologic morphology and immunohistochemical phenotypes of sarcomatoid carcinoma(SC) of the fallopian tube.Methods One case of SC of the fallopian tube was studied under the light microscopy for morphology.Immunohistochemistry was used to detect the expression of CK,EMA,S-100,Desmin,SMA,Leu-7,CD68,actin,and Vimentin in SC tissues.Pathologic features and biological behaviors of SC were analyzed in combination with the review of literature.Results Microscopically carcinomatous and sarcomatous elements co-existed.Usually the sarcomatous element formed the bulk of the lesion.In the sarcomatous tissues,there was no distinguishable bone,cartilage,rhadomyosarcoma,etc. Immunohistochemically the strong expression of CK7,EMA and Vimentin,and the partial expression of S-100,SMA,Leu7,CD68 and actin were detected.Conclusion SC of the fallopian tube is lack of specific symptoms,and its preoperative diagnosis is difficult.B-ultrasonography,CT and MRI are helpful to the staging of SC.Final diagnosis of SC depends on pathological examination and immunohistochemistry.SC is rare,and undergoes blood metastasis in early stage.Prognosis of SC is worst.Early detection of SC is the key to improve the prognosis.