原发性骨小细胞肿瘤的病理形态和免疫组化分析

Pathologic diagnosis of primary small round cell tumors of the bone

目的 :探讨免疫组化染色及病理形态在原发性骨小细胞肿瘤鉴别诊断中的意义。方法 :对 39例骨的小细胞肿瘤 [其中尤因肉瘤 /外周性原始神经外胚层肿瘤 (EW/PNET瘤 ) 2 2例、小细胞骨肉瘤 6例、间叶性软骨肉瘤 3例和恶性淋巴瘤 8例 ],观察其病理形态并作免疫组化分析 ,所用抗体为O13、NSE、S 10 0、Actin和LCA。结果 :EW /PNET瘤 2 0 / 2 2例为O13阳性。NSE :EW /PNET瘤 16 / 2 2例和 1例骨肉瘤阳性。 7例EW /PNET瘤、1例骨肉瘤及 3例间叶性软骨肉瘤均有S 10 0阳性。所有恶性淋巴瘤的LCA均为阳性。骨肉瘤均见骨样基质 ,间叶性软骨肉瘤可见分化较好的软骨岛。结论 :O13的染色对于EW /PNET瘤有诊断意义。

Objective: To study the diagnosis and differentiation of primary small round cell tumors of bone. Methods: Thirty nine cases were studied by light microscopy and immunochemistry of O13,NSE,S 100,Actin and LCA. Results: 20/22 cases of EW/PNET were positive for O13.16/22 cases of EW/ PNET and one case of small cell osteosarcoma were positive for NSE.S 100 was positive in EW/PNET,small cell osteosarcoma and mesenchymal chondrosarcoma. All malignant lymphomas were positive for LCA.6 cases of small cell osteosarcoma have osteoid production. Islands of cartilage were found in mesenchymal chondrosarcoma. Conclusion: O13 is a specific valuable marker for the diagnosis of EW/PNET. Histologic features of the osteoid in osteosarcoma and the cartilage in mesenchymal chondrosarcoma are important for the diagnosis.