平滑肌肉瘤的临床病理研究─—病理组织学、免疫组化及超微结构分析

THE CLINICAL PATHOLOGIC STUDY OF LEIOMYOSARCOMA ANANALYSI5 OF HISTOPATHOLOGY,IMMUNOHISTOCHEMI- STRY AND ULTRASTRUCTURES

本文报道对２６例全身多个部位的平滑肌肉瘤（ＬＭｓ）附病理组织学、ＨＨＦ３５及Ｄｅｓｍｉｎ免疫组化及部分病例还进行了超微结构特征研究。结果表明ＬＭＳ具有较典型的组织学特征：瘤细胞呈杆状，平行排列，胞浆内有肌原纤维。低分化的ＬＭＳ细胞异型性大，但仍具有上述特征。Ｄｅｓｍｉｎ标记ＬＭＳ的阳性率是６５％，ＨＨＦ３５的阳性率是９６％。两者有显著性差异。其它对照的多种梭形细胞肉瘤中，除恶性纤维组织细胞瘤中可有少数、单个的细胞呈ＨＨＦ３５阳性外，其它均不表达ＨＨＦ３５和Ｄｅｓｍｉｎ。因此ＨＨＦ３５是标记ＬＭＳ的敏感性高、特异性强的抗体。透射电镜观察ＬＭＳ具有特征性的密体和密斑存在。透射电镜观察也是确诊ＬＭＳ的途径之一。

Twenty six cases of Leiomy osarcomas(LMS)were studid in ourseries.we analysed the histopathology,immunohistochemistry of Desmin and HHF35 ofall cases,features of ultrastructures of 4 cases as well.The prominant histologic featu-res are blunted- ended nucleus arranging in straight parallel lines,and longitudinal myo-fibril presence in cytoplasm. These features can also be identified in poorly differentiatedones.Sixty five percent of LMS expressed Desmin,while ninety six percent of them ex-pressed HHF35.HHF35 is more sensitive one for the detection of LMS,and there is nodifference in sensitivity between well,morderately and poorly differentiated LMS statisti-cally. Apart from there is a few scattered positive cells of HHF35 in Malignant FibrousHistiocytomas,the other spindle cell sarcomas are negative for Desmin and HHF35.SoHHF35 is a good marker for smooth muscle differentiation。There are some specific fea-tures of ultrastructure in LMS,so electron microscopic examination is a good tool forthe diagnosis of LMS.