Wincewicz Andrzej, Lewitowicz Piotr, Sulkowska Urszula, Sulkowski Stanislaw, Horecka-Lewitowicz Agata, Koziel Dorota, Gluszek Stanislaw
Department of Anatomy, Faculty of Health Sciences, Jan Kochanowski Memorial University, Kielce, Poland.
Folia Histochem Cytobiol. 2013;51(4):339-42. doi: 10.5603/FHC.2013.0046.
Histochemical and immunohistochemical methods should often but not always complement standardized histopathologic procedures. Here, we illustrate use of these ancillary techniques in a report of scrotal leiomyosarcoma. 62-year-old male patient presented with a palpable, subcutaneous 2,5 cm wide tumor arising from dartos muscle. The tumor was diagnosed leiomyosarcoma G2 pT1b. Interestingly, the sarcomatous mass was focally strictly attached to convoluted, benign bundles of smooth muscles that were intermingled with tumor mass at peripheral, lateral and superior sides of the lesion. We have used immune- and histochemical methods to confirm histopathological findings based on H&E staining. As expected, in tumor cells smooth muscle actin and desmin were strongly immunopositive similarly as Masson trichrome staining, while S100 and CD34 antigens were immunonegative except for sustained positivity for CD34 in vessels. The auxiliary staining methods can provide additional information on the tumorigenesis of leiomyosarcoma. They can also serve to determine additional features of prognostic significance, since e.g. immunoreactivity of CD34 accurately maps vascular density of tumor and enables a careful assessment of vascular invasion in course of leiomyosarcoma as well.
组织化学和免疫组织化学方法常常（但并非总是）能补充标准化的组织病理学程序。在此，我们在一篇阴囊平滑肌肉瘤的报告中阐述这些辅助技术的应用。一名62岁男性患者，阴囊可触及一个源自肉膜肌的皮下肿瘤，直径2.5厘米。该肿瘤被诊断为G2 pT1b级平滑肌肉瘤。有趣的是，肉瘤块局部紧密附着于迂曲的良性平滑肌束，这些平滑肌束在病变的外周、外侧和上侧与肿瘤块相互交织。我们使用免疫组织化学和组织化学方法，基于苏木精-伊红（H&E）染色来确认组织病理学发现。正如预期的那样，在肿瘤细胞中，平滑肌肌动蛋白和结蛋白免疫反应强烈，与马森三色染色结果相似，而S100和CD34抗原免疫阴性，但血管中CD34持续阳性。辅助染色方法可为平滑肌肉瘤的肿瘤发生提供额外信息。它们还可用于确定具有预后意义的其他特征，例如，CD34的免疫反应性可准确描绘肿瘤的血管密度，也有助于在平滑肌肉瘤病程中仔细评估血管侵犯情况。
