伴有广泛骨化和钙化的滑膜肉瘤:2例报告及文献复习

Synovial sarcoma with extensive ossification and calcification:A report of two cases and literature review

目的:探讨2例伴有广泛骨化和钙化的滑膜肉瘤患者的临床病理特征及鉴别诊断要点,以提高临床上对该肿瘤的认识。方法:对2例伴有广泛骨化和钙化的滑膜肉瘤患者的临床病理资料进行复习。对肿瘤组织行免疫组织化学EnVision二步法染色,检测细胞角蛋白(cytokeratin,CK)、上皮膜抗原(epithelial membrane antigen,EMA)、Bcl-2、CD99和TLE1的表达;荧光原位杂交技术检测SS 18-SSX融合基因。结果:2例患者均为双相型滑膜肉瘤。免疫组织化学检测结果显示,2例患者肿瘤组织中CK和EMA的表达均呈灶片状阳性,Bcl-2、CD99和TLE1的表达均呈阳性;均检测到SS 18-SSX基因易位融合。结论:伴有广泛骨化和钙化的滑膜肉瘤较为罕见,易与骨肉瘤等成骨性肿瘤相混淆,应结合免疫组织化学和分子学检测以协助诊断。

Objective： To explore the clinicopathological features and differential diagnosis of 2 patients with synovial sarcoma with extensive ossification and calcification in order to improve the understanding of the tumorMethods： The clinical and pathological information of 2 patients with synovial sarcoma with extensive ossification and calcification was reviewed. The EnVision two-step immunohistochemical staining technique was used to detect the expressions of cytokeratin （CK）, epithelial membrane antigen （EMA）, Bcl-2, CD99 and TLE1. The fluorescence in situ hybridization was used to detect the SS18-SSX fusion gene. Results： Both patients were diagnosed of biphasic synovial sarcomaThe immunohistochemical results showed that CK and EMA positive, the Bcl-2, CD99 and TLE1 expressions were posit translocation fusion was detected. expressions were foci-like ve, and the SS18-SSX gene Conclusion： Synovial sarcoma with extensive ossification and calcification is rare and easily to be confused with osteogenic tumors including osteosarcoma. It should be combined with immunohistochemistry and molecular detection to assist diagnosis.