Kojima M, Nakamura S, Itoh H, Ohno Y, Masawa N, Joshita T, Suchi T
Department of Pathology, Dokkyo University School of Medicine, Mibu, Tochigi, Japan.
Mod Pathol. 1999 Jul;12(7):739-43.
Mast cell sarcoma is a rare disease. We report an unusual case of this neoplasm arising in the ascending colon of a 32-year-old Japanese woman who presented with abdominal pain. An ulcerating mass in the colon was resected, along with enlarged mesenteric lymph nodes. Two years after surgery, the neoplasm recurred as left cervical lymphadenopathy and an intra-abdominal mass. Despite predonine and radiation therapy, the disease progressed, and the patient died. The tumor cells had abundant fine granular or clear cytoplasm, and oval, lobulated, or indented nuclei. Numerous mature eosinophils were intermingled with the tumor cells. Immunohistologic studies on paraffin sections demonstrated that the majority of the tumor cells were strongly positive for CD45RB, CD68, and mast cell tryptase. They were unreactive, however, with a broad spectrum of antibodies against myelomonocytic and lymphocytic antigens. The mast cell nature of this rare type of tumor can be best identifiable by immunostains for mast cell tryptase.
肥大细胞肉瘤是一种罕见疾病。我们报告了一例不寻常的该肿瘤病例，发生于一名32岁出现腹痛的日本女性的升结肠。结肠中的一个溃疡性肿块连同肿大的肠系膜淋巴结被切除。术后两年，肿瘤复发为左颈部淋巴结病和腹腔内肿块。尽管使用了泼尼松龙和放射治疗，疾病仍进展，患者死亡。肿瘤细胞具有丰富的细颗粒状或透明细胞质，以及椭圆形、分叶状或凹陷的细胞核。大量成熟嗜酸性粒细胞与肿瘤细胞混合。石蜡切片的免疫组织学研究表明，大多数肿瘤细胞对CD45RB、CD68和肥大细胞类胰蛋白酶呈强阳性。然而，它们对一系列抗骨髓单核细胞和淋巴细胞抗原的抗体无反应。这种罕见类型肿瘤的肥大细胞性质通过肥大细胞类胰蛋白酶免疫染色最易识别。
