血管肉瘤临床病理与免疫病理研究

Angiosarcoma: a clinicopathological study of 6 cases

目的探讨血管肉瘤的临床病理特征。方法收集6例血管肉瘤标本,做网状纤维染色(RF染色)及CD31、CD34和Ki-67、PCNA、P53等免疫组化染色,其中3例做电镜观察,分析其临床病理特点。结果6例中男性4例,女性2例,年龄17～66岁,平均46岁。临床呈侵袭性,易复发。其中上皮样血管肉瘤2例。RF染色部分区域清晰显示血管轮廓,瘤细胞位于管腔内侧,免疫组化染色阳性表达CD31为5例,CD34为4例;Ki-67为4例,PCNA为5例,P53为2例。电镜观察可见瘤细胞内有少数Weibel-Palade小体(W-P小体),有微饮泡,细胞外偶见不连续的基板(2/3)。结论血管肉瘤是一种少见的高度恶性肿瘤,好发于中老年人,组织学变化差异大,诊断要着重注意发病部位、年龄、形态特点、伴随病变、RF染色及CD31表达情况。

ObjectiveTo study the clinicopathological features of angiosarcoma.MethodsThe clinical and patho-logical data of 6 cases with angiogenesis were reviewed retrospectively. Reticular fibers were studied by Gordon-Sweetsmethod.All cases were examined by immunohistochemistry and 3 cases by electromicroscopic observation.ResultsTherewere 4 male and 2 female with average age of 46 years old, Which ranged from 17 to 66 years old. The course of the diseasewas aggressive and recrudescent readily. 2 cases were epithelioid angiosarcoma. The studies of reticular fibers demonstratedclearly that vascular compartment encysted tumor cells. lmmunohistochemically, CD31 was positive in 5/6, CD34in 4/6, Ki-67 in 4/6, PCNA in 5/6, and P53 in 2/6 cases. Electromicroscopic study demonstrated occasionally cytoplasmic Weibel-Paladebodies, pinocytotic vesicles, and the discontinuous basal laminae (2/3). ConclusionsAngiosarcoma is an extremely ag-gressive neoplasm. It is rare and generally angiosarcoma occurr in middle and old people. Histological picture of angiosarcomais variform. It is important for the diagnosis of angiosarcoma to pay close attention to the site, age, histological picture,concomitant pathological changes, stains of reticular fibers and immunohistochemical findings of CD31.