多次复发的腹膜后脂肪肉瘤的病理形态学和生物学行为观察.docVIP

???? 多次复发的腹膜后脂肪肉瘤的?病理形态学和生物学行为观察 ???? ????【摘要】　目的　观察腹膜后多次复发性脂肪肉瘤的病理形态学特点、生物学行为和鉴别诊断。方法　收集了10例腹膜后脂肪肉瘤病人的临床资料，组织切片除行HE染色外，还运用免疫组织化学LSAB法行S-100、肌动蛋白、波形蛋白和肌红蛋白等染色。对10例32个原发和复发肿瘤标本进行了大体和显微镜下观察。结果　本组中6/8例原发肿瘤和13/24例复发肿瘤为硬化性脂肪肉瘤，其组织学特征是分化较好的梭形细胞呈束状或车轮状排列，肿瘤内含分化性脂肪肿瘤成分。本组10例腹膜后脂肪肉瘤在20个月～10年间于腹膜后1～7次肿瘤复发，仅1例发生1次远处转移。本组中5例在肿瘤复发、转移过程中发生了组织学亚型的转化。结论　本组中硬化性脂肪肉瘤是腹膜后脂肪肉瘤最常见的组织学亚型；腹膜后脂肪肉瘤经常局部复发，远处转移少见，反覆切除复发肿瘤可延长病人生存期。　　【关键词】　脂肪肉瘤　　腹膜后肿瘤 The patho-morphology and biological behavior of repeatedly recurrent liposarcoms in retroperitoneum　ZHANG Changhuai. Department of Pathology, Beijing Friendship Hospital, Beijing 100050　　【Abstract】　Objective　To investigate the patho-morphological features and biological behavior of repeatedly recurrent liposarcomas in retroperitoneum as well as the differential diagnosis with other malignant mesenchymal tumors. Methods　Totally 10 patients accompanied with detailed clinical data. Except HE staining, immunohistochemical assays for S-100 actin, vimentin and myoglobin were also used for 32 specimens. Results　6/8 cases of the primary and 13/24 cases of the recurrent tumors of this group were diagnosed as sclerosing liposarcoma with spindle cell proliferation arranged in fascicles and whorls. Ten retroperitoneal tumor recurred within 20 months～10 years, and among them, distant metastasis obtained only in one case. The histologic subtypes of recurrent and metastasized tumors became varied in 5 cases. Conclusion　Sclerosing liposarcoma was the most common histological subtype, see in retroperitoneal liposarcoma, local recurrence frequent, but distant metastasis rare. Surgical removal of the recurrent tumors might prolong the survival expectation of these patients.　　【Key words】　Liposarcoma　　Retroperitoneal neoplasms 　　腹膜后是脂肪肉瘤，特别是硬化性脂肪肉瘤的好发部位，我们对10例腹膜后脂肪肉瘤的32个原发和复发性肿瘤标本进行了仔细观察。旨在了解该肿瘤所具有的形态学和生物学特点，以及如何与其他间叶性肿瘤进行鉴别。 材料和方法　　一、标本收集　　收集北京友谊医院1972～1995年间手术切除的腹膜后脂肪肉瘤10例，32个标本（不包括2例含脂肪肉瘤成分的恶性间叶瘤）。7例获得了原发肿瘤及所有复发肿瘤（2～7次）共29个标本；其他3例中1例原发肿瘤及前3次复发肿瘤均在外院切除，我们看到了第