大网膜滤泡树突状细胞肉瘤临床病理观察

Pathological features of follicular cell Sarcoma of gastrocolic omentum:A case report and review of the literature

目的:探讨大网膜滤泡树突状细胞肉瘤的临床与病理学特点、诊断和鉴别诊断,提高对其诊治水平。方法:运用组织病理学、免疫组织化学观察1例大网膜滤泡树突状细胞肉瘤的特点并结合文献加以分析。结果:肿瘤位于大网膜,镜下肿瘤由束状、片状、旋涡状排列的短梭形、卵圆形或多边形瘤细胞组成,具有围绕血管呈同心圆样排列的特征,部分区域类似脑膜瘤形态,其周可见较多混杂的小淋巴细胞。肿瘤内可见凝固性坏死灶。免疫表型:瘤细胞表达CD21、CD23、CD68,EMA弱表达。结论:滤泡树突状细胞肉瘤是一种罕见的低度恶性肿瘤,发生于大网膜者极为罕见,其诊断与鉴别诊断主要依赖组织病理学及免疫组化标记。

Objective： To investigate the clinical and pathologic characteristics for improving pathological and differential diagnosis of the follicular cell sarcoma of gastrocolic omentum. Methods ： One specific case of follicular cell sarcoma of gastrocolic omentum was determined by histopathology and immunohistochemistry for the pathological features and compared with corresponding documents. Results ： The tumor was histologically seen in gastrocolic omentum, and the follicular cell sarcoma demonstrated itself by microscopic formation of whorls, fascicles of spindle and syncytoid or polygonality cells intermingling with small lymphocytes, circular structure with a fibrovascular core. Part of the tumor morphologically resembled the shape of durosarcoma and ischemic necrosis was observed intra-tumorally. Immunohistochemlcally, the expression in tumors was positive for CD21, CD23 and CD68, but with weak expression of EMA. Conclusion ： The follicular cell sarcoma of gastrocolic omentum is a rare low-grade malignant tumor and the differential diagnosis of it should be based on the histopathology and immunohistochemistry.