磷酸盐尿性间叶肿瘤的临床病理学分析.PDF

中华临床医师杂志( 电子版)2014 年10 月第8 卷第20 期 Chin J Clinicians(Electronic Edition),October 15,2014,Vol.8,No.20 ·3611 · ·临床论著· 磷酸盐尿性间叶肿瘤的临床病理学分析 李道胜 【摘要】 目的 探讨磷酸盐尿性间叶肿瘤的临床病理学特点。方法 回顾分析10 例患者的临 床资料，观察 10 例磷酸盐尿性间叶肿瘤的形态及免疫表型。结果 患者男6 例，女4 例，年龄范围 23～55 岁，平均43.1 岁；患者均有1～13 年骨痛、关节痛和活动困难的病史，检查发现低血磷、高 尿磷；肿瘤最大径0.8～5 cm 不等（平均3.05 cm ）；瘤组织为间叶组织来源，可见多少不等的梭形 纤维母细胞样细胞、脂肪细胞、软骨样细胞、黏液样细胞等，瘤组织富于血管，4 例病变中有少见 的絮状或不规则砂砾样钙盐沉积，3 例发生于软组织的肿瘤周边见骨壳形成；8 例细胞分裂象少见， 2 例核分裂象多见并且异型性明显；瘤细胞VIM 及CD56 阳性，7 例NSE 阳性，3 例Bcl-2 瘤细胞 阳性，结蛋白、S-100、AE1/AE3 均阴性，Ki-67 指数8 例1%～5%，仅2 例为20%～30% 。结论 磷 酸盐尿性间叶肿瘤多为良性或低度恶性的间叶组织肿瘤，因组织学多种多样而易误诊，掌握其共同 的特征性并结合临床资料方能正确诊断。 【关键词】 病理学，临床； 磷酸盐尿性间叶肿瘤； 低磷酸盐血症  Clinicopathologic study of phosphaturic mesenchymal tumor Li Daosheng. Department of Pathology, The Central Hospital of Taian, Taian 271000, China Email: Lds163.com 【Abstract 】 Objective To study the clinicopathologic features of phosphaturic mesenchymal tumor. Methods The clinical and pathologic findings of 10 cases of phosphaturic mesenchymal tumor were evaluated. Hematoxylin and eosinstain, immunohistochemistry and histochemistry were performed on the archival paraffin sections. Results Amongst the 10 patients studied, 6 were males and 4 were females. Their age at the time of operation ranged from 23 to 55 years (mean=43.1 years). A history of long standing bone pain, arthralgia, limitation in movement, hypophosphatemia and hyperphosphaturia was present in all cases. The duration of symptoms ranged from 1 to 13 years. The tumor size ranged from 0.8 to 5 cm (mean size=3.05 cm). Microscopically, the tumors were composed of various mesenchymal cells, including spindled fibroblast-like cells, adipocytes, chondroid cells and mucinous cells. The backgro