肱骨变异类型软骨肉瘤临床病理研究.docVIP

肱骨变异类型软骨肉瘤临床病理研究【摘要】目的探讨肱骨变异类型软骨肉瘤的临床病理特征、诊断及鉴别诊断要点。方法对1例肱骨变异类型软骨肉瘤的临床资料、影像学、组织学形态和免疫表型进行分析。结果左肱骨肿物的组织学镜下示瘤组织侵犯骨膜及骨髓腔，其中骨周肿块以粘液样软骨肉瘤为主，骨髓腔内可见分化好的软骨岛，血管外皮瘤样区和尤文氏瘤样区，组织学图像倾向于间叶性软骨肉瘤。免疫组化显示瘤细胞Vimentin、CD99、S100阳性。结论肱骨变异类型软骨肉瘤较罕见，组织学形态表现多样，诊断较为困难。应认真观察HE染色切片，加以免疫组化标记辅助检查。其确诊有待临床、影像、组织形态学和免疫组化四结合。 【关键词】肱骨;变异类型软骨肉瘤;临床病理 The clinical and pathological analysis of humerus variant chondrosarcomaZHOU Xuan, LI Zhanyu, LIN Yujing Department of Pathology，The fifth Affiliated hospital, SUN YATSEN university, zhuhai 519000,China 【Abstract】ObjectiveTo investigate the clinicopathologic features,diagnosis and differential diagnosis of the humerus variant chondrosarcoma MethodsTo analyze the clinical information, imaging, histological morphology and immunophenotype of one case of humerus variant chondrosarcomas ResultsThe left humerus tumor histology microscopically show that tumor invade the periosteum and bone marrow cavity, the lump of Bone around show the histological morphology of myxoid chondrosarcoma, bone marrow cavity performed for the chondrocytes Island, a hemangiopericytomalike zone and Ewings tumor, histological images tend to the mesenchymal chondrosarcoma Immunohistochemistry showed Vimentin, CD99, S100 is positive to the tumor cells ConclusionHumerus variant chondrosarcoma is a rare tumor It showed various of histological morphology, It is difficult to be diagnosed Should be carefully observed by HE staining sections, auxiliary examination by immunohistochemical markers Its diagnosis need the combination of clinical, imaging, histological morphology and immunohistochemistry. 【Key words】Humerus； Variant chondrosarcoma; Clinical pathology 作者单位：519000珠海市中山大学附属第五医院病理科软骨肉瘤是一种成软骨来源的恶性肿瘤，发病率为1908%，仅次于骨肉瘤。根据组织结构可将其分为两个主要类型：普通型软骨肉瘤和变异类型软骨肉瘤，每个类型又都包括几个亚型，亚型的界定有的是根据镜下特点，有的是根据受累骨的病变位置。普通型软骨肉瘤约占所有软骨肉瘤的90%，发病年龄多为30～60岁，男性多于女性，好发于骨盆，其次为股骨、肋骨、胫骨及肩胛骨等。主要症状为疼痛及肿块。根据发病部位分为中心型、周边型和皮质旁(骨膜)三种类型［1］。而变异型软骨肉瘤较罕见，包括透明细胞软骨肉瘤、粘液样软骨肉瘤、去分化软骨肉瘤、间叶性软骨肉瘤。其镜下组织学形态多样，由此给我们临床病理诊断