Gould E W, Manivel J C, Albores-Saavedra J, Monforte H
Department of Pathology, University of Miami/Jackson Memorial Hospital, Florida.
Cancer. 1990 Jan 15;65(2):310-8. doi: 10.1002/1097-0142(19900115)65:2<310::aid-cncr2820650221>3.0.co;2-q.
Six cases of locally aggressive and/or potentially malignant glomus tumors are described. On the basis of clinical and pathologic criteria, the following classification is proposed. The first category is a locally infiltrative glomus tumor (LIGT) which has the usual glomus histologic features. The second group is a cytologically malignant tumor arising and merging with a typical glomus tumor, designated glomangiosarcoma arising in a benign glomus (GABG). The third category and the most difficult to recognize is the de novo glomangiosarcoma (GADN), which must be distinguished from other round cell sarcomas. Most of these locally aggressive glomus tumors are vimentin positive and are immunoreactive for muscle-specific actin. Electron microscopic examination in one GABG case showed cells with numerous microfilaments and pinocytotic vesicles; a second GADN case contained cells with microfilaments and an incomplete basal lamina. As a group these locally aggressive or potentially malignant glomus tumors are larger and more deeply located than the conventional glomus tumor. Although 50% of these tumors recurred locally, none have metastasized.
本文描述了6例具有局部侵袭性和/或潜在恶性的血管球瘤。基于临床和病理标准，提出以下分类。第一类是具有典型血管球组织学特征的局部浸润性血管球瘤（LIGT）。第二类是起源于典型血管球瘤并与之融合的细胞性恶性肿瘤，称为起源于良性血管球瘤的血管肉瘤（GABG）。第三类也是最难识别的是原发性血管肉瘤（GADN），它必须与其他圆形细胞肉瘤相鉴别。这些具有局部侵袭性的血管球瘤大多波形蛋白阳性，对肌肉特异性肌动蛋白呈免疫反应性。对1例GABG病例的电子显微镜检查显示细胞含有大量微丝和吞饮小泡；另一例GADN病例的细胞含有微丝和不完整的基膜。作为一个群体，这些具有局部侵袭性或潜在恶性的血管球瘤比传统的血管球瘤更大且位置更深。虽然这些肿瘤中有50%发生局部复发，但均未发生转移。
