摘要
目的:探讨淋巴结内指突状树突细胞肉瘤的临床病理特征、诊断要点及鉴别诊断。方法:对1例腹股沟淋巴结内指突状树突细胞肉瘤进行组织病理学和免疫组化染色观察并随访,结合文献进行讨论。结果:镜下显示淋巴结结构破坏,细胞呈梭形、圆形、椭圆形,肿瘤细胞弥漫分布,异性型明显,可见核分裂象,经化疗后肿瘤内可见片状凝固性坏死。免疫表型:瘤细胞表达Vimentin、CD68和S-100蛋白。结论:淋巴结内指突状树突状细胞肉瘤是一种罕见的免疫辅助细胞恶性肿瘤。其诊断依靠组织病理学和免疫组化染色,必要时电镜辅助诊断。应与滤泡树突细胞肉瘤、朗格汉斯细胞组织细胞增生症、恶性纤维组织细胞肉瘤、恶性黑色素瘤、间变性梭形细胞癌及其他肉瘤鉴别。治疗以手术切除为主,辅以化疗和(或)放疗,预后差。
Objective：To study the clinicopathologic features,diagnosis and differential diagnosis of interdigitating dendritic cell sarcoma（IDCS）. Methods：One case of IDCS in the inguinal lymph node was evaluated by light microscopy and immunohistochemistry. Results： Microscopically, the lymph node structure was destroyed, the tumor displayed a characteristic biphasic pattern which was composed of plump spindle - shaped, round or oral cells . The neoplastic cells exhibited a magnificent degree of nuclear atypia, with occasionally identified mitotic figures. After medical treatment, coagulative necrosis was observed ,The neoplastic cells were positive for Vimentin, CD68, and S -100 protein. Conclusion：IDCS is a rare malignant tumor with poor prognosis, electron microscopy and immunohistochemistry are necessary for the diagnosis. IDCS should be treated by complete excision with adjuvant chemotherapy or radiotherapy if necessary, and differential diagnosis includes follicular dendritic cell sarcoma, Langerhans cell histiocytosis, malignant fibrous histiocytoma, melanoma, metastatic spindle cell carcinoma and other sarcomas.
出处
《现代肿瘤医学》
CAS
2009年第2期325-328,共4页
Journal of Modern Oncology
关键词
腹股沟肿瘤
指突状树突细胞肿瘤
淋巴结
免疫组化
诊断
鉴别诊断
inguinal neoplasms
interdigitating dendritic cell sarcoma
lymph node
immunohistochemistry
diagnosis
differential diagnosis
