Górecki Tomasz, Ostrowska Magdalena, Kaszuba Barbara, Nowicki Przemysław, Dudzik Tomasz, Wojnowski Sebastian
Department of Pathomorphology, District Hospital, Konin.
Pol J Pathol. 2005;56(3):145-7.
An 83-year-old woman was admitted to our hospital because of colicky pain under the right costal arch suggesting cholecystitis. Physical examination confirmed by ultrasound scan indicated a palpable tumor in that location. Laparotomy was performed and the tumor was removed. Histopathological examination revealed malignant peripheral nerve sheath tumor (MPNST) originating in neurofibroma of the mesentery. Macroscopic, histological and cytological features were typical for MPNST. High nuclear pleomorphism, hyperchromasia were observed but on average only two mitotic figures per high power field were seen. The growth fraction determined by Ki-67 immunoreactivity was about 30%. Immunohistochemical stains revealed positivity of individual cells for NK-1(CD57), S-100 protein and NSE. It was lack of positivity for cytokeratin, EMA, vimentin, desmin, SMA, CD34. We report a well documented case of MPNST originating in preexisting neurofibroma of the mesentery. To our knowledge, is the first case in the Polish literature.
一名83岁女性因右肋弓下绞痛提示胆囊炎而入住我院。体格检查经超声扫描证实该部位可触及肿瘤。遂行剖腹手术并切除肿瘤。组织病理学检查显示为起源于肠系膜神经纤维瘤的恶性外周神经鞘瘤（MPNST）。宏观、组织学和细胞学特征均为MPNST的典型表现。可见高核多形性、核深染，但平均每高倍视野仅见两个有丝分裂象。通过Ki-67免疫反应性测定的生长分数约为30%。免疫组织化学染色显示个别细胞对NK-1（CD57）、S-100蛋白和NSE呈阳性。细胞角蛋白、EMA、波形蛋白、结蛋白、平滑肌肌动蛋白、CD34呈阴性。我们报告了一例有充分记录的起源于肠系膜原有神经纤维瘤的MPNST病例。据我们所知，这是波兰文献中的首例。
