皮肤上皮样肉瘤临床病理分析

Clinicopathological Analysis of Epithelioid Sarcoma of the Skin

目的报告1例罕见的多部位受累的上皮样肉瘤。方法回顾性分析患者的临床及病理资料、治疗及随访,并复习相关文献。结果患者男,47岁,先后发现腰部、颏下、耳前、头皮多部位肿块达十余个,组织病理检查示肿瘤由上皮样细胞和梭形细胞构成肉芽肿样结构,位于真皮胶原束之间,中央大片状坏死,肿瘤细胞轻-中度异型性。免疫组化显示细胞角蛋白(AE1/AE3)、上皮细胞膜抗原(EMA)和波形蛋白(vimentin,VIM)阳性,S-100和CD34灶状阳性。结论上皮样肉瘤是临床少见的软组织低度恶性肿瘤,多发性者罕见,容易误诊为良性肉芽肿性病变或其他恶性肿瘤,应引起临床及病理医师的足够重视。

Objective A case of rare multiple epithelioid sarcoma involving several sites of the skin was reported. Methods Retrospective analysis about the patient＇s clinical and pathological data, therapy, and follow-up was given. Meanwhile, relative references were reviewed. Results A 47-year-old male patient presented with multiple nodules successively in the waist, submentum, preauricula and scalp, totally more than 10. Histopathological examination showed grannloma-like structure with central necrosis between dermal collagen bundles, comprised of epithelioid and spindle cells and with mild-moderate atypia, lmmunohistochemical resuits manifested the tumor cells were positive for cytokeratin, EMA （epithelial membrane antigen） and vimentin,focally positive for S-100 and CD34. Conclusions Epithelioid sarcoma was a rare low-grade malignant tumor of soft tissue especially muhifocality, which is easy to be misdiagnosed as benign granuloma or some other malignancies and should to be highlighted.