Hashimoto K, Matsumoto M, Eto H, Lipinski J, LaFond A A
Arch Dermatol. 1985 Jun;121(6):742-6.
A chronic brawny edema developed in the shoulder and arm ipsilateral to the site of a previous mastectomy in a 68-year-old woman. Bluish nodules and telangiectasia admixed with more superficial papules and plaques developed subsequently. Histologically, many of these lesions showed angiocentric clusters of large hyperchromatic tumor cells, often with lumina in the center. It was difficult to differentiate two possibilities, ie, postmastectomy angiosarcoma in lymphedema (Stewart-Treves syndrome) and nodulotelangiectatic metastasis of the original breast carcinoma. Monoclonal anti-keratin antibody and anti-desmosome antibody identified keratin and desmosomes in the tumor cells, whereas staining with factor VIII-related antigen yielded negative results. Electron microscopy revealed, in addition to keratin filaments and desmosomes, typical secretory cells and lumen formation. A combined use of specific monoclonal and polyclonal antibodies is helpful in the determination of tumor origins.
一名68岁女性在先前乳房切除术部位同侧的肩部和手臂出现慢性硬结性水肿。随后出现了蓝色结节和毛细血管扩张，并混杂有更表浅的丘疹和斑块。组织学上，许多这些病变显示大的深染肿瘤细胞呈血管中心性聚集，中心常可见管腔。很难区分两种可能性，即淋巴水肿中的乳房切除术后血管肉瘤（斯图尔特-特雷夫斯综合征）和原发性乳腺癌的结节性毛细血管扩张性转移。单克隆抗角蛋白抗体和抗桥粒抗体在肿瘤细胞中鉴定出角蛋白和桥粒，而因子VIII相关抗原染色结果为阴性。电子显微镜检查除了发现角蛋白丝和桥粒外，还发现了典型的分泌细胞和管腔形成。特异性单克隆抗体和多克隆抗体联合使用有助于确定肿瘤来源。
