Medina Pérez M, Valero Puerta J, Valpuesta Fernández I, Pérez Martín D
Servicio de Anatomía Patológica, Hospital de la Merced, Osuna, Sevilla, España.
Arch Esp Urol. 1999 May;52(4):393-5.
To describe a rare case of intrascrotal malignant fibrous histiocytoma.
A 90-year-old man presented with a scrotal mass which he had noted during the past few months. A scrotal tumor, 8 cm in diameter, was detected on physical evaluation. Tumor resection was decided due to the patient's good general condition despite his age.
The histological analysis confirmed a sarcomatoid neoplasm with pleomorphism. The immunohistochemical analysis demonstrated strong overexpression of vimentin, alpha-1-antichymotrypsin, CD68 (Kpl), p53 oncoprotein and elevated Ki67. The ultrastructural study showed undifferentiated mesenchymal cells. The diagnosis of intrascrotal malignant fibrous histiocytoma was made based on the foregoing findings.
Malignant fibrous histicytoma should be included in the differential diagnosis of intrascrotal tumors. Histological, immunohistochemical and ultrastructural studies are very important to distinguish the different paratesticular sarcomas. The strong overexpression of the p53 oncoprotein may be involved in the pathogenesis of this tumor type.
描述一例罕见的阴囊恶性纤维组织细胞瘤病例。
一名90岁男性患者在过去几个月中发现阴囊有肿物。体格检查发现一个直径8厘米的阴囊肿瘤。尽管患者年龄较大，但鉴于其一般状况良好，决定进行肿瘤切除。
组织学分析证实为具有多形性的肉瘤样肿瘤。免疫组化分析显示波形蛋白、α-1抗胰凝乳蛋白酶、CD68（Kpl）、p53癌蛋白强烈过表达，且Ki67升高。超微结构研究显示未分化的间充质细胞。根据上述结果诊断为阴囊恶性纤维组织细胞瘤。
恶性纤维组织细胞瘤应列入阴囊肿瘤的鉴别诊断。组织学、免疫组化和超微结构研究对于区分不同的睾丸旁肉瘤非常重要。p53癌蛋白的强烈过表达可能参与了这种肿瘤类型的发病机制。
