Hiroshima K, Uruma T, Ishibashi M, Ohwada H, Hayashi Y
Division of Pathology, School of Medicine, Chiba University, Japan.
Acta Pathol Jpn. 1992 Oct;42(10):755-9. doi: 10.1111/j.1440-1827.1992.tb03227.x.
A 39-year-old male was admitted complaining of nonproductive cough and dyspnea on exertion. Death occurred eight months after onset of the symptoms. Autopsy examination showed that the pulmonary trunk and left main pulmonary artery were markedly dilated and completely occluded by a tumor. The tumor had infiltrated into the left upper lobe and mediastinal lymph nodes, and metastatic nodules were found in both lungs and in the left adrenal gland. Small foci of infarction were noted in the lower lobes of both lungs. The tumor cells were of two types; pleomorphic spindle cells and bizarre multinucleated giant cells. Immunohistochemically, they were positive for vimentin, myosin, and lysozyme, but negative for desmin and muscle-specific actin. The cytoplasm of the tumor cells was showed by electron microscopy to contain microfilaments, dense bodies, and pinocytotic vesicles. We diagnosed this case as undifferentiated sarcoma of the pulmonary artery. Approximately 100 cases of pulmonary artery sarcoma have been reported. Histopathologically, almost all of the reported cases showed both spindle cells and pleomorphic giant cells, indicating a biologically anaplastic neoplasm.
一名39岁男性因干咳和劳力性呼吸困难入院。症状出现8个月后死亡。尸检显示，肺动脉主干和左主肺动脉明显扩张，并被一个肿瘤完全阻塞。肿瘤已浸润至左上叶和纵隔淋巴结，双肺及左肾上腺均发现转移结节。双肺下叶可见小梗死灶。肿瘤细胞有两种类型：多形性梭形细胞和奇异的多核巨细胞。免疫组化显示，它们波形蛋白、肌球蛋白和溶菌酶呈阳性，但结蛋白和肌肉特异性肌动蛋白呈阴性。电镜显示肿瘤细胞胞质内含有微丝、致密体和吞饮小泡。我们将此病例诊断为肺动脉未分化肉瘤。肺动脉肉瘤已报道约100例。组织病理学上，几乎所有报道的病例均显示有梭形细胞和多形性巨细胞，提示为生物学上的间变性肿瘤。
