淋巴结转移性透明细胞肉瘤2例临床病理分析

Analysis of clinical pathology on two patients with metastatic clear cell sarcoma of lymph node

目的探讨淋巴结转移性透明细胞肉瘤的临床病理特征、诊断及鉴别诊断要点。方法观察2例病理诊断为淋巴结转移性透明细胞肉瘤患者的临床特征,从肿瘤组织的组织学形态及免疫组织化学结果进行分析。结果 2例患者腹股沟淋巴结内均见转移性的肿瘤组织,肿瘤主要由胞质丰富而透明的多角形细胞或梭形细胞组成,并被纤维组织分隔呈大小不等的巢状及束状,并见多核巨细胞、出血及坏死灶。追溯病史,2位患者1年及1·5年前曾行外踝及膝盖上方肿物切除术,两者均为半年前发现腹股沟肿物。免疫组化染色示肿瘤细胞Vimentin、S-100、HMB-45及Melan-A均阳性。结论淋巴结转移性透明细胞肉瘤诊断较为困难,应积极追溯病史,注重HE染色下形态学观察,免疫组化标记有帮助。

Objective To investigate points on clinical and pathological features,diagnosis,differential diagnosis of metastatic clear cell sarcoma of lymph node Methods Observing clinical features of two patients pathologically diagnosed metastatic clear cell sarcoma of lymph node,and analyzing the results of histology and immunohistochemistry from tumor tissue Results The inguinal lymph nodes metastatic tumor was positive in two patients Tumor tissue that was separated nest and bundle of varying sizes by fibrous tissue consisted of polygonal cells with rich and transparent cytoplasm or spindle cells There were some multinucleated giant cells,hemorrhage and necrosis in tissue Retrospective history,two patients underwent the lateral malleolus or above the knee tumor resection ever before one to one and half year Both the groin mass were found six months ago Vimentin,S 100,HMB 45 and Melan A of tumor cells all were positive by immunohistochemical stain Conclusion It is difficult to diagnose for metastatic clear cell sarcoma of lymph node We should review history and focus on morphology with HE stain Immunohistochemistry also is helpful.