Imai Kazuhiro, Saito Hajime, Minamiya Yoshihiro, Hashimoto Masaji, Kimura Yoshihiko, Ogawa Jun-ichi
Division of Thoracic Surgery, Department of Surgery, Akita University School of Medicine, and Akita Kumiai General Hospital, 1-1-1 Hondo, Akita, 010-8543, Japan.
Gen Thorac Cardiovasc Surg. 2008 Dec;56(12):606-9. doi: 10.1007/s11748-008-0305-0. Epub 2008 Dec 16.
A 63-year-old man with a history of acute coronary syndrome presented with anterior chest pain that had lasted more than 3 months. During treatment for acute myocardial infarction on admission, computed tomography (CT) was performed incidentally, revealing an anterior mediastinal tumor 28 mm in diameter. CT findings after 3 months demonstrated an anterior soft tissue mass involving the left brachiocephalic vein and showing rapid growth. Radical resection of the tumor with thymectomy was performed. Histological examination showed storiform-pleomorphic malignant fibrous histiocytoma (MFH) originating from the thymus, and Hassall's bodies were identified. Immunohistochemical staining showed tumor cells with positive results for vimentin and CD68. The Ki-67 index (MIB-1) was >50%, but other markers such as cytokeratin AE1/AE3, smooth muscle actin, S-100 protein, CD34, and CD45 were negative. Mediastinum MFH has been reported in 34 cases, but this appears to be a rare description of MFH originating from the thymus.
一名有急性冠状动脉综合征病史的63岁男性，出现持续3个多月的前胸痛。入院治疗急性心肌梗死期间，偶然进行了计算机断层扫描（CT），发现一个直径28毫米的前纵隔肿瘤。3个月后的CT结果显示一个累及左头臂静脉的前软组织肿块，并呈现快速生长。遂行肿瘤根治性切除术并切除胸腺。组织学检查显示为起源于胸腺的席纹状-多形性恶性纤维组织细胞瘤（MFH），并发现了哈氏小体。免疫组化染色显示肿瘤细胞波形蛋白和CD68呈阳性结果。Ki-67指数（MIB-1）>50%，但细胞角蛋白AE1/AE3、平滑肌肌动蛋白、S-100蛋白、CD34和CD45等其他标志物均为阴性。纵隔MFH已有34例报道，但这似乎是对起源于胸腺的MFH的罕见描述。
