Rao Shalinee, Arcot Rekha, Pai Vishwanath, Prathiba D
Department of Pathology, Sri Ramachandra Medical College and Research Institute, Chennai.
Indian J Pathol Microbiol. 2007 Oct;50(4):795-7.
Giant cell rich malignant fibrous histiocytoma accounts for 3 -15% of all malignant fibrous histiocytomas. Currently, the nomenclature giant cell malignant fibrous histiocytoma is reserved for undifferentiated pleomorphic sarcomas with prominent osteoclastic giant cells. It is considered to be synonymous with malignant giant cell tumor of soft parts. We report a case of disseminated giant cell malignant fibrous histiocytoma involving the scalp, cervical node, lungs, spine, abdominal wall, base of penis, gluteal cleft, paraspinal region and back. The diagnosis was established after staining for a panel of immunohistochemical markers namely cytokeratin, vimentin, S100, desmin, CD68 and smooth muscle actin. CD68 positivity in tumor cells helped in arriving at the final diagnosis. It is essential to recognize this tumor as a giant cell rich distinct entity and differentiate from other giant cell rich pleomorphic sarcomas since therapeutic and prognostic differences are being appreciated currently.
富含巨细胞的恶性纤维组织细胞瘤占所有恶性纤维组织细胞瘤的3% - 15%。目前,巨细胞恶性纤维组织细胞瘤这一命名用于具有显著破骨样巨细胞的未分化多形性肉瘤。它被认为与软组织恶性巨细胞瘤同义。我们报告一例播散性巨细胞恶性纤维组织细胞瘤,累及头皮、颈部淋巴结、肺、脊柱、腹壁、阴茎根部、臀裂、椎旁区域和背部。通过一组免疫组织化学标志物染色,即细胞角蛋白、波形蛋白、S100、结蛋白、CD68和平滑肌肌动蛋白,确立了诊断。肿瘤细胞中CD68阳性有助于做出最终诊断。必须将这种肿瘤识别为富含巨细胞的独特实体,并与其他富含巨细胞的多形性肉瘤相鉴别,因为目前正在认识到治疗和预后的差异。