摘要
目的:探讨成人鼻部胚胎型横纹肌肉瘤(Embryonal Rhabdomyosarcoma,ERMS)的临床病理特点,以提高对该病的认识。方法:结合文献对本院病理科诊断和会诊的2例成人鼻部ERMS的临床资料、组织形态及免疫组化结果进行分析。结果:2例均为男性。组织学形态示瘤细胞呈片状或团块状,之间有较少的纤维间隔,瘤细胞为染色质丰富的圆形或梭形细胞,核染色质较浓,可见轻度嗜酸性细胞质。免疫组化:肿瘤细胞肌调节蛋白、肌浆蛋白、肌红蛋白、肌动蛋白(肌原节)、肌动蛋白(广谱)、结蛋白和波形蛋白均(+)、角蛋白(广谱)、上皮细胞膜抗原、白细胞共同抗原、平滑肌肌动蛋白、S-100蛋白、黑色素瘤、CD34、神经元特异性烯醇化酶和CD99均(-)。结论:成人鼻部ERMS临床表现无特异性,易误诊。CT是诊断鼻部ERMS的重要检查方法。组织病理学特点结合免疫组化标记可确诊该肿瘤。早期诊断及手术联合放、化疗是治疗成人鼻部ERMS的有效手段。
Objective：To examine clinical and pathological features of adult nosal embryonal rhabdomyosarcoma and to investigate the effective diagnosis and prognosis.Methods：The adult nasal ERMS specimens collected by the Pathology Department of Yichang Central People＇s Hospital were analyzed.For both patients,representative hematoxylin and eosin-stained slides of tumors were available for review.Immunohistochemical stains（SP method） were performed on a selected paraffin block.And the information of clinical diagnosis and treatment was reviewed.Results：The 2 cases were male.ERMS was characterized by an admixture of undifferentiated,small,round or spindle cells which were rich in chromatin and were separated into patchy form or mass by scanty fibrous septa.The nuclear chromatin was thick with eosinophilic cytoplasm.Immunohistochemically,the tumor cells were positive for MyoD1,myogenin,myoglobin,Actin（Sarcomeric）,Actin（pan）,desmin and Vimentin,but negative for Cytokeratin（pan）,Epithelial Membrane Antigen（EMA）,CD45（LCA）,Actin（Smooth Muscle）,S-100 Protein,Melanoma（HMB-45）,CD34,Neuron Specific Endolase（NSE）and CD99.Conclusion：Adult nasal ERMS has no specific clinical features,so it＇s often misdiagnosed.CT is an important method to provide us with important clues to the diagnosis of ERMS,and its final diagnosis mainly depends on histopathological and immunohistochemical findings.Early diagnosis and surgery combined with radiotherapy and chemotherapy are effective treatment for adult nasal ERMS.
出处
《重庆医科大学学报》
CAS
CSCD
北大核心
2011年第8期1014-1017,共4页
Journal of Chongqing Medical University
关键词
横纹肌肉瘤
胚胎型
鼻肿瘤
免疫组化
rhabdomyosarcoma
embryonal
nasal neoplasms
immunohistochemistry
