Department of Histopathology, Royal Marsden NHS Foundation Trust, 203 Fulham Road, London SW3 6JJ, UK.
Clin Oncol (R Coll Radiol). 2009 Nov;21(9):695-705. doi: 10.1016/j.clon.2009.07.016. Epub 2009 Sep 6.
Sarcomas are a rare, complex group of childhood and adult neoplasms with differentiation towards mesenchymal tissue, which may arise almost anywhere in the body. Although pathologically diverse, they frequently exhibit similar clinical presentations and radiological features. Correct histopathological diagnosis is therefore crucial, but there is overlap between histological patterns of malignant tumours, between benign and malignant lesions, and with non-mesenchymal tumours. Immunohistochemistry and molecular genetic techniques, the latter to detect tumour-specific alterations, add significantly to histological interpretation, but several groups of tumours still lack reliable immunohistochemical markers or reproducible genetic changes. The classification of sarcomas is incomplete and continues to evolve, and although the biology of many remains relatively poorly understood, our increasing insight into molecular events occurring in these tumours is certain to aid future diagnosis and therapy. This paper aims to give a broad overview of several of the main soft tissue sarcomas from a clinicopathological perspective, discussing laboratory diagnosis and the use and limitations of ancillary investigations, including recent developments in molecular diagnosis.
肉瘤是一种罕见且复杂的儿童和成人生殖细胞瘤，其分化方向为间叶组织，可发生在身体的任何部位。尽管在病理学上存在多样性，但它们经常表现出相似的临床表现和影像学特征。因此，正确的组织病理学诊断至关重要，但恶性肿瘤的组织学模式、良性和恶性病变之间以及非间叶性肿瘤之间存在重叠。免疫组织化学和分子遗传学技术，后者用于检测肿瘤特异性改变，对组织学解释有很大帮助，但仍有几类肿瘤缺乏可靠的免疫组织化学标志物或可重复的遗传改变。肉瘤的分类不完整，仍在不断发展，尽管许多肉瘤的生物学特性仍相对不为人知，但我们对这些肿瘤中发生的分子事件的了解不断加深，肯定有助于未来的诊断和治疗。本文旨在从临床病理学的角度对几种主要的软组织肉瘤进行广泛概述，讨论实验室诊断以及辅助检查的应用和局限性，包括分子诊断的最新进展。
