Hasegawa T, Hasegawa F, Hirose T, Sano T, Matsuno Y
Pathology Division, National Cancer Centre Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
J Clin Pathol. 2003 Sep;56(9):666-71. doi: 10.1136/jcp.56.9.666.
To obtain further information regarding the frequency and degree of positivity for smooth muscle markers in a large number of malignant fibrous histiocytomas (MFHs), as an aid to accurate diagnosis.
The immunohistochemical features of 100 MFHs were studied and the results were compared with those for 30 leiomyosarcomas. Eighteen cases of MFH with smooth muscle actin (SMA) positivity were examined ultrastructurally.
Immunoreactivity for smooth muscle markers, such as desmin, SMA, muscle specific actin (MSA) and h-caldesmon (HCD), which is a specific marker for smooth muscle cells and their tumours, was found in 28, 30, 29, and 29 of 30 leiomyosarcomas. Immunoreactivity for desmin, SMA, MSA, and HCD was found in 17, 30, 14, and two of the MFHs. On electron microscopic examination, approximately half of the cases contained a varying proportion of myofibroblastic cells. The others had only fibroblastic or undifferentiated tumour cells. At least 30% of the cases were found to display features consistent with limited smooth muscle or myofibroblastic differentiation.
A large subset of so called MFH in fact shows poorly differentiated smooth muscle or myofibroblastic features, and perhaps such tumours should be regarded as pleomorphic leiomyosarcomas and/or pleomorphic myofibroblastic sarcomas.
获取更多关于大量恶性纤维组织细胞瘤（MFH）中平滑肌标志物阳性频率和程度的信息，以辅助准确诊断。
研究了100例MFH的免疫组化特征，并将结果与30例平滑肌肉瘤的结果进行比较。对18例平滑肌肌动蛋白（SMA）阳性的MFH病例进行了超微结构检查。
在30例平滑肌肉瘤中，分别有28例、30例、29例和29例对结蛋白、SMA、肌肉特异性肌动蛋白（MSA）和h - 钙调蛋白（HCD，平滑肌细胞及其肿瘤的特异性标志物）呈免疫反应。在MFH中，结蛋白、SMA、MSA和HCD的免疫反应阳性病例分别为17例、30例、14例和2例。电子显微镜检查显示，约一半的病例含有不同比例的肌纤维母细胞。其他病例仅有纤维母细胞或未分化的肿瘤细胞。至少30%的病例表现出与有限的平滑肌或肌纤维母细胞分化一致的特征。
实际上，很大一部分所谓的MFH表现出低分化的平滑肌或肌纤维母细胞特征，或许此类肿瘤应被视为多形性平滑肌肉瘤和/或多形性肌纤维母细胞肉瘤。
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