CAJ | 학술논문

目的探讨近端型上皮样肉瘤(PES)的临床病理特点、诊断及鉴别诊断依据.方法收集5例PES患者资料,免疫组织化学EnVision法染色.第一抗体选用细胞角蛋白(CK)、波形蛋白、上皮细胞膜抗原(EMA)、CD34、β-catenin、S-100蛋白、平滑肌肌动蛋白(SMA)、肌调节蛋白(MyoD1)、结蛋白、HMB45、CK7及CK20,观察和分析其临床病理学形态及免疫表型特征.结果 5例PES中女1例,男4例;发病年龄19-46岁,发生部位分别为:会阴部2例,下腹部、髂前上棘和臀部各1例,均表现为进行性增大的无痛性单发肿块.光镜下肿瘤细胞呈结节状排列,浸润性生长,瘤细胞大部分由相对独特的上皮样细胞组成,胞质丰富,嗜酸性;核卵圆形,肿瘤中心常见坏死.免疫组织化学染色示5例瘤细胞均表达波形蛋白,4例表达CK、EMA,3例表达β-catenin、CD34,1例表达S-100蛋白;而SMA、MyoD1、结蛋白、HMB-45、CK7及CK20均阴性.结论根据PES组织学和病理学特征,结合免疫组织化学染色结果可以做出明确诊断.
목적 탐토근단형상피양육류(PES)적림상병리특점、진단급감별진단의거.방법 수집5례PES환자자료,면역조직화학EnVision법염색.제일항체선용세포각단백(CK)、파형단백、상피세포막항원(EMA)、CD34、β-catenin、S-100단백、평활기기동단백(SMA)、기조절단백(MyoD1)、결단백、HMB45、CK7급CK20,관찰화분석기림상병이학형태급면역표형특정.결과 5례PES중녀1례,남4례;발병년령19-46세,발생부위분별위:회음부2례,하복부、가전상극화둔부각1례,균표현위진행성증대적무통성단발종괴.광경하종류세포정결절상배렬,침윤성생장,류세포대부분유상대독특적상피양세포조성,포질봉부,기산성;핵란원형,종류중심상견배사.면역조직화학염색시5례류세포균표체파형단백,4례표체CK、EMA,3례표체β-catenin、CD34,1례표체S-100단백;이SMA、MyoD1、결단백、HMB-45、CK7급CK20균음성.결론 근거PES조직학화병이학특정,결합면역조직화학염색결과가이주출명학진단.
Objective To investigate the clinicopathological characteristics,diagnosis and differential diagnoses of proximal-type epithelioid sarcoma (PES). Methods Five cases of PES were retrieved from pathology Fries. Clinical,pathologic and immunohistochemical features of the tumors were reviewed. Results One patient was female and 4 were male. Ages of the patients ranged from 19 to 46 years. The sites of the tumor involvement were vulvar (2 cases),hypogastric zone ( 1 case),anterosuperior iliac spine (1 case) and buttock (1 case). Clinically,the tumor masses were painless and progressive solitary nodules. Microscopically,the tumor cell growth was infiltrative in nature,nodular in appearnce with degenerative and necrotic ceils at the central areas. The tumors consisted of relatively uniform epithelioid cells with round or oval nuclei and eosinophilic cytoplasm,Immunohistochemically,the tumor cells were positive for vimentin (5/5),CK (4/5),EMA (4/5),β-catenin (3/5),CD34 (3/5),and S-100 protein (1/5),but were negative for SMA,MyoD1,Desmin,HMB-45,CK7 and CK20. Conclusion Definitive diagnosis of PES relies on its histopathological characteristics in conjunction with appropriate immunohistochemical findings.