干旱区生态环境知识资源中心(Arid): 腹腔软组织平滑肌肿瘤临床病理分析

Arid

	腹腔软组织平滑肌肿瘤临床病理分析
其他题名	Smooth muscle tumors in abdominal soft tissue: a clinicopathological study
	侯英勇; 谭云山; 许建芳; 王岫南; 宿杰·阿克苏; 周燕南; 曾海英; 高峰; 郑爱华; 朱雄增
ISSN	1001-7399
出版年	2006
卷号	22 期号:4 页码:397-401
中文摘要	目的探讨腹腔软组织平滑肌肿瘤临床病理、免疫组化、超微结构特点及鉴别诊断.方法用desmin、alpha-SMA、MSA以及CD117、CD34为主的一组抗体对腹腔软组织原诊断为平滑肌瘤、平滑肌母细胞瘤及平滑肌肉瘤等病例进行研究,获得34例腹腔、系膜及腹膜后平滑肌肿瘤,其中2例行超微结构观察.结果男性8例,女性26例,年龄26～77岁,平均47.6岁,中位年龄48岁,其中腹膜后28例,肠系膜4例,腹腔2例,肿瘤直径5～18 cm,平均9.86 cm.梭形细胞型32例,其中1例伴有反应性破骨样巨细胞,1例有高度恶性软组织肉瘤区域(即去分化平滑肌肉瘤),上皮型和混合型各1例.此组抗体表达分别为desmin(21/22)、alpha-SMA(21/21)、MSA(21/21)、CD117(1/21)、CD34(1/21)、S-100蛋白(3/21)、PGP9.5(2/21).超微结构可见基板、质膜下连续的微饮泡、胞质内丰富的密体和密斑,而细胞器较少.其中4例检测c-kit基因11号外显子序列,均为野生型.平滑肌瘤4例,其中2例分别健在5年和10年;交界性1例;平滑肌肉瘤29例,获访13例,11例(85.0%)在3年内复发、转移或死亡,1例5年后死亡,仅1例无瘤生存10年.结论腹腔软组织平滑肌肿瘤主要发生于腹膜后,女性多见,以恶性居多,肿瘤性坏死、核分裂象≥4/50 HPF及细胞明显异型性对判断恶性有重要参考价值.需与相同部位的胃肠道外间质瘤、恶性神经鞘膜瘤等鉴别.
英文摘要	Purpose To explore the clinieopalhological, inimiitMihislochcmical and ullrastructural features of smoolh muscle lumors in abdominal soft tissue and their differential diagnosis. Methods Tliirty-four eases of smooth muscle lumors from the abdominal cavity or retroperitoneum were studied. Results The lumors occurred in 8 men and 26 women, wilh age ranged from 26 to 77 years ( mean 47. 6 years) , in which Iwenly-eighl cases arose from ihe relroperitoneum, 4 from mesentery and 2 from abdominal cavily. The size of lumors ranged from 5 to 18 em (mean 9. 86 cm) in diameter and the tumor cell components varied, mainly spindle cells (32 cases) , in which one case was accompanied wilh reaelive gianl cells and one case displayed area of high grade pleomorphie sarcoma (dediffer-entiated leioinyosareoma area) , epilhelioid cells (one cases) , and mixed cells (one case). Tumors expressed desmin( 21/22), ot-SMA(21/21) , MSA(21/21) , CDl 17( 1/21) , CD34( 1/21 ) , S-100(3/21 ) , and PGP9. 5(2/21 ). Klectron microscopically, continuous basal lamina, regular caveolae, and dense plaque were observed. Four cases were leiomyomas, one case was borderline and 29 eases were leioinyosareoma. Follow-up of 2 oases of leiomyomas showed loug-lerm survival of 5 years and 10 years, In the leiomyosareo-mas group, follow-up information was available in 13 eases, in which 11 cases developed recurrence, metastasis or death within 3 years, one cases died of disease in 5 years, and only one cases survived for 10 years without tumor. Conclusions The smoolh muscle tumor of abdominal soft tissue; mainly occurs in relroperitoneum. Mosl cases are female and malignant. The features of tumor coagula-tive necrosis, mitoses ^4 per 50 high-power fields and obvious nuclear atypia indicate malignancy. Differential diagnosis includes gastrointestinal stromal lumors, malignanl nerve sheath tumors and others.
中文关键词	平滑肌肉瘤 ; 腹膜后肿瘤 ; 胃肠道外间质瘤 ; 诊断,鉴别
英文关键词	desmin CD117 leioinyosareoma relroperitoneal neoplasms extra-gastrointestinal slronial Iumor desmin CDl 17 diagnosis, differential
语种	中文
国家	中国
收录类别	CSCD
WOS类目	MEDICINE GENERAL INTERNAL ; ONCOLOGY
WOS研究方向	General & Internal Medicine ; Oncology
CSCD记录号	CSCD:2421374
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/219935
作者单位	复旦大学附属中山医院病理科, 上海 200032, 中国
推荐引用方式 GB/T 7714	侯英勇,谭云山,许建芳,等. 腹腔软组织平滑肌肿瘤临床病理分析[J],2006,22(4):397-401.
APA	侯英勇.,谭云山.,许建芳.,王岫南.,宿杰·阿克苏.,...&朱雄增.(2006).腹腔软组织平滑肌肿瘤临床病理分析.,22(4),397-401.
MLA	侯英勇,et al."腹腔软组织平滑肌肿瘤临床病理分析".22.4(2006):397-401.