阴茎假血管肉瘤样鳞状细胞癌1例及文献复习

Pseudoangiosarcomatous squamous cell carcinoma of penis:a case report with review of literature

目的 探讨阴茎假血管肉瘤样鳞状细胞癌 (SCC)的诊断、组织学和免疫组化特征以及鉴别诊断。方法 通过HE、免疫组化及特殊染色观察 1例阴茎原发假血管肉瘤样鳞状细胞癌 ,并复习文献。结果 镜下可见显著的棘细胞松解 ,肿瘤由排列呈腔隙状、网状结构的长梭形细胞组成 ,细胞异型性明显 ,核分裂象易见 ,胞质大多红染 ,局部区域弥漫出血坏死。免疫表型 :CK、Vim阳性 ,CD34、CD31、SMA、FⅧRAg阴性。网状纤维染色不显示血管外形。结论 假血管肉瘤样SCC是一种罕见的易与血管肉瘤混淆的特殊形态的SCC ,需与血管肉瘤。

Purpose To study the histological and immunohistological features, and differential diagnosis of pseudoangiosarcomatous squamous cell carcinoma(SCC) of the penis. Methods A case of primary pseudoangiosarcomatous SCC of the penis was investigated by means of light microscopy, HE stain, silver stain and immunohistochemical strains for CK, Vim, CD34, CD31, SMA and FⅧRAg. Results Microscopically, the tumor was composed of large spindle cells, which lined in complex anastomosing vascular-like channels and spaces puctuated with small irregular nests. The acantholytic changes, cytological atypia and mitotic figures of the tumor cells were prominent. Immunohistochemically, the tumor cells were positive for CK and Vim, but negative for CD34, CD31, SMA and FⅧRAg. Ag staining revealed no vascular channels. Conclusion Pseudoangiosarcomatous SCC is a rare subtype of SCC with a dramatic similarity to angiosarcoma under microscope, which occurs occasionally in the penis. Therefore angiosarcoma and carcinosarcoma should be included in its differential diagnosis.