腹膜后具有血管周上皮样细胞分化肿瘤1例报道及文献复习.docVIP

腹膜后具有血管周上皮样细胞分化肿瘤1例报道及文献复习【摘要】 目的 探讨具有血管周上皮样细胞分化的肿瘤临床病理特点。方法 对1例腹膜后具有血管周上皮样细胞分化的肿瘤的临床病理组织学及免疫表型进行观察并结合文献复习。结果 患者体检发现盆腔包块,术中见腹膜后偏左相当于髂内外动脉分叉下方有一10×8×6 cm3大小不规则包块。镜下见上皮样肿瘤细胞环绕血管生长排列,大部分细胞呈圆形或多边形,也可见少数梭形细胞,胞浆呈透明至细颗粒状,核位于中央,呈圆形或椭圆形,染色质正常,核仁小,细胞有明显异型性,免疫组化标记HMB45(+),SMA(+),CK(-),S-100(-)。结论 腹膜后PEComas非常罕见,其有独特的细胞组织学特征和明确的免疫组化表型,但其良恶性标准及预后仍待进一步探讨。 【关键词】 血管周上皮样细胞;免疫组化;腹膜后 Retroperitoneal with perivascular epithelioid cell differentiation of the tumor a case report and literature review 【Abstract】 Objective To study the clinicopathological features of tumours showing perivascular epithelioid cell differentiation(PEComas).Methods Observe the clinicopathological and immunohistochemical features of a patient with PEComa in retroperitoneumand review literatures.Results Physical examination was found in patients with pelvic mass. Intraoperative peritoneal see below left internal and external iliac artery bifurcation is equivalent to the bottom of a 10 × 8 × 6 cm3 size of the irregular mass. Microscopically, epithelioid tumor cells arranged around the blood vessel growth, most cells were round or polygonal, can also be found a small number of spindle cells, clear to finely granular cytoplasm, nuclear is located in the central, round or oval, chromatin normal, small nucleoli, cell marked atypia. Immunohistochemical markers HMB45 (+), SMA (+), CK (-), S-100 (-).Conclusion Retroperitoneal PEComas is very rare. It has unique tissue characteristics and specific immunohistochemical phenotype. Its standards and prognosis of benign or m alignant remains to be further explored. 【Key words】 PEC;Immunohistochemistry;Retroperitoneal 具有血管周上皮样细胞分化的肿瘤非常少见,尤其是非AML、CCST和LAM的PEComas更加罕见,其临床表现,病理学诊断及预后均在探讨之中,笔者报道1例腹膜后PEComa,并复习相关文献。 1 资料与方法 1.1 临床资料 患者女,45岁,体检发现盆腔包块2 d,于2009年4月2日来合肥市第二人民医院就诊。既往月经规则,已闭经3个月,病程中偶有腹痛,有时有排尿不尽感,查体:T 36℃,P90次/min,Bp116/88 mm Hg,WBC 9.7×109/L,Hb99 g/L,子宫左后方扪及一8×8 cm2大小肿块,质硬,压痛(+)。B超示:盆腔左侧显示一83×68×104 mm3大小的不均质性较低回声区,周界尚清晰,不规则。2009年4月8日11点50分行“盆腔左侧腹膜后肿瘤