软组织肿瘤病理学病例讨论 四课件.pptVIP

Case 4 EX05-146 (04/S10052). Presented by Q H Fan. History. Female aged 12. Subcutaneous lesion extending down to bone on the dorsum of the right middle finger. Diangosis? The differential diagnosis includes:  1. Cutaneous fibrous histiocytoma 2. Plexiform neurofibroma, 3. Fibromatosis, 4. Benign and malignant giant cell tumors Prognosis Twenty of their 32 cases (Good: 62.5%) with follow-up information were alive and well after local excision, but the tumor recurred in 12 cases (Recurred: 37.5%). In two patients with recurrence, the disease (Metastasized: 6%) metastasized to regional lymph nodes 9 and 36 months after the initial excision, respectively. Enzinger and Zhang’s original findings have been confirmed in subsequent papers. Treatment Plexiform fibrohistiocytic tumor is a low grade soft tissue tumor of intermediate malignancy which frequently recurs locally but rarely metastasizes. Wide excision is believed to be the best treatment. Case 5 (Slide Seminar Case 04BX5833) Presented by: Dr. Wai-Kuen Ng讲者：吴伟权医生 Division of Anatomical Pathology, Department of Pathology Clinical Biochemistry, Queen Mary Hospital, Hong Kong SAR, China 香港玛丽医院病理及临床生化学部门 Clinical History 病历 10-year-old boy with torticollis bilateral upper limb weakness for 3 months 患者男，10岁。因斜颈及双手无力达3个月而就诊。 Spine X-ray: Osteolytic lesion over C2 vertebral body 脊柱X线：有一溶骨性病变在C2颈椎骨中。 Bone scan: Increased uptake in C1 to C3 region 骨扫描：C1至C3位置摄取量增加。 MRI: Tumor mass arising from C2 vertebral body compressing on spinal cord 磁脊振显像：有一C2颈椎骨肿瘤，并压著脊髓。 Tumor debulking (04BX5833) performed 肿瘤主体切除术标本送检。 Histologic Diagnosis?组织学诊断? Histologic Differential Diagnosis组织学鉴别诊断 Tumor with epithelioid cells 含上皮样细胞肿瘤: - Epithelioid MPNST 上皮样恶性神经鞘瘤 - Epithelioid sarcoma 上皮样肉瘤 - Epithelioid angiosarcoma 上皮样血管肉瘤 - Epithelioid leiomyosarcoma 上皮样平滑肌肉瘤 - Epithelioid synovial sarcoma 上皮样滑膜肉瘤 - Metastatic carcinoma / mesothelioma / melanoma 转移性癌、间皮瘤或黑色素瘤 Histologic Differential Diagnosis