上皮样肉瘤

Epithelioid sarcoma:a case report

报告1例跖部上皮样肉瘤。患者男,40岁。右足跖部结节2年,溃疡4～5个月。皮肤科检查:右足跖中央一5 cm×2 cm、深约1 cm的溃疡,周边少许肉芽样组织生长。皮损组织病理检查:真皮中下部可见栅状肉芽肿样瘤细胞团块,中央有坏死表现,周边主要由上皮样细胞和梭形细胞组成,核分裂象增多。免疫组化染色显示肿瘤细胞表达细胞角蛋白(CK)、上皮膜抗原(EMA)、波形蛋白(vimentin)和CD34,而不表达CD31和S-100蛋白。患者的临床表现、组织病理改变及免疫组化染色均符合上皮样肉瘤的特点。

A case of epithelioid sarcoma on the sole of foot is reported. A 40-year-old male patient presented with a gradually increasing, painful subcutaneous nodule on the right sole for two years, and the nodule ulcerated four to five months ago. Physical examination showed an ulcer on the right sole measuring 5 cm × 2 cm in width, 1 cm in depth. The ulcer was irregular with punched out and raised edges. The base was finn and the floor was covered with granulation tissue. Histopathologic examination revealed a typical annulare granuloma-like pattern of tumor cells surrounding a necrotic focus in mid and lower dermis, which composed mainly of diffuse sheets of epithelioid and spindle-shaped tumor cells. Mitosis was increased. Immunohistochemieal studies showed that tumor cells were positively stained for eytokeratin （CK）, epithelial membrane antigen （EMA）, vimentin and CD34, but they were negative for CD31 and S-100 protein. The clinical, pathological and immunohistoehemical feature of this case supported the diagnosis of a conventionaltype epithelioid sarcoma.