骨原发性上皮样血管肉瘤2例报道并文献复习.pdfVIP

· 546 · 临床与实验病理学杂志 JClinExpPathol 2012May；28(5) 骨原发性上皮样血管肉瘤 2例报道并文献复习 张海芳 一，李德本。，张新华 ，周 军 ，余 波 ，周晓军 摘要：目的 提高对骨原发性上皮样血管肉瘤 (epithelioidangiosarcoma，EA)的认识 ，避免误诊。方法 对2例原发于骨的EA 进行临床病理、组织学及免疫组化分析，并进行文献复习。结果 2例均为男性，为骨组织内的多灶性、溶骨性病变，组织学上 肿瘤主要由实性片状排列的上皮样细胞组成，瘤细胞核大 ，空泡状，含有明显核仁，可见细胞内空泡和血管腔样结构形成。免 疫组化标记显示瘤细胞表达CD31、FVI~RAg、cK、vimentin。分别进行单纯化疗和手术治疗。1例失访，1例2个月后死亡。结 论 骨原发性 EA是一种具有上皮样特征的高度恶性血管源性肿瘤，必须与转移癌等鉴别，CD31、cK等血管标记物对鉴别诊 断具有重要的意义。 关键词：血管肉瘤；骨肿瘤；诊断；鉴别诊断 中图分类号：R738．7 文献标志码 ：A 文章编号：1001—7399(2012)05—0546—05 Epithelioidangiosarcomaofbone：areportoftwocasesandreview ofliteratures ZHANGHai．fang ，U De．ben，ZHANGXin—hua，ZHOUJun，YUBo，ZHOUXiao-jun (DepartmentofPathology，MedicalSchoolofNanjingUniversity／NanjingGeneralHospitalofP ，Ⅳn ng 210002，Chi— na；。DepartmentofPathology，the fAffiliatedHospitalofXiamenUniversity，Xiamen 361003，China；DepartmentofPathology， the97thHospitalofPL4，Xuzhou 221000，China) Abstract：Purpose Toincreasetheunderstandingofepithelioidangiosarcomaoccurredinthebonetissueandavoid misdiagnosis． Methods Twocasesofepithelioidangiosarcomaoccurredinthebonewereanalyzedbyclinic0pathol0gical，histologicalandimmuno— histochemicalstaining，andrelevantliteratureswerereviewed．Results Alltwocasesweremale．Radiographicimagingsshowedmul— tiofealosteolyticlesions．Histologically，thetumorconsistedpredominantlyofsolidsheetsoflargeepithelioidcellswithlargevesicular nucleiandprominentnucleoli．Introcytoplasmicvacuolescontainedredbloodcellsandwell—formedvascularchannelslinedbytumor ceilswerealsonotedinsomeareas．Immunohistochemically，thetumorcellsstainedpositiveforCD31，factorⅧ-relatedantigen，CK andvimentin．Thepatientsweretreatedwith chemotherapyorsurgeryrespectively．Onecasewaslosttofollow-up，andonedied2 monthsafterdiagnosis．Conclusions Primary epithelioidangiosarcomaofboneisahigh-grademalignanttumorwithepithelioidofa— turesmorphologically，anditshoulddifferentfrom otherepitheliodtumorssuchasmetastaticcarcinomaandSOon．Vasculra markers (especiallyCD31)areveryi