Antonini C, Zucconelli R, Forgiarini O, Chiara A, Briani G, Belmonte P, Fiaccavento G, Sacchi G
Division of Anatomical and Istological Pathology, Ospedale di S Doná di Piave (VE), 30027, Italy.
Adv Clin Path. 1997 Oct;1(4):281-285.
Carcinosarcomas (sarcomatoid carcinomas) are controversial, biphasic tumors composed of both carcinomatous and sarcomatous elements. They are uncommon and occur in numerous locations. At the time of this report only 3 cases of carcinosarcoma of penis have been reported in the literature. The aim of this article is to provide a discussion of these lesions, using informations gleaned from the pertinent literature as well as the personal experience of the authors. METHODS: The formalin-fixed paraffin-embedded tissue was stained with hematoxylin and eosin, reticulum, alcian blue and Mallory's trichrome stains. Section from selected paraffin-embedded blocks, were stained with antibodies to citokeratins, EMA, vimentin, desmin, and a actin. RESULTS: In our case the carcinomatous elements were admixed with areas of "divergent differentiation": spindle-cell and giant-cell sarcomatoid component with bone and cartilage differentiation were noted. In situ carcinoma was also detected. Immunohistochemistry showed reactivity for keratin and epithelial membrane antigen (EMA). In most of pleomorphic spindle elements. Immunoreactivity for vimentin, desmin and actin were focally found. CONCLUSIONS: The carcinosarcomas may demonstrate "divergent" differentiation into bone, cartilage or myogenous tissue, so it is possible that the cell of origin could be heterogeneous. In our case myogenous differentiation was focally found. Although the clinical data, available from the only three cases of the literature, demonstrate that the behaviour of this tumors was not different from those of squamous cell carcinoma, the authors recommended a constant careful follow-up of the patients.
癌肉瘤（肉瘤样癌）是一种有争议的双相性肿瘤，由癌性和肉瘤性成分组成。它们并不常见，可发生于多个部位。在本报告撰写之时，文献中仅报道了3例阴茎癌肉瘤。本文旨在利用从相关文献以及作者个人经验中收集到的信息，对这些病变进行讨论。方法：将福尔马林固定石蜡包埋组织进行苏木精和伊红染色、网状纤维染色、阿尔辛蓝染色和马洛里三色染色。从选定的石蜡包埋块中切取切片，用细胞角蛋白、上皮膜抗原（EMA）、波形蛋白、结蛋白和α肌动蛋白抗体进行染色。结果：在我们的病例中，癌性成分与“异向分化”区域混合存在：可见具有骨和软骨分化的梭形细胞和巨细胞肉瘤样成分。还检测到原位癌。免疫组化显示角蛋白和上皮膜抗原（EMA）呈阳性反应。在大多数多形性梭形细胞中，波形蛋白、结蛋白和肌动蛋白的免疫反应呈局灶性阳性。结论：癌肉瘤可能表现为向骨、软骨或肌源性组织的“异向”分化，因此其起源细胞可能是异质性的。在我们的病例中，局灶性发现了肌源性分化。尽管从文献中仅有的3例病例获得的临床数据表明，这种肿瘤的行为与鳞状细胞癌无异，但作者建议对患者进行持续密切的随访。
