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梭形细胞/硬化性横纹肌肉瘤:来自单一机构的病例系列,重点关注形态学、免疫组织化学及随访情况

Spindle cell/sclerosing rhabdomyosarcoma: case series from a single institution emphasizing morphology, immunohistochemistry and follow-up.

作者信息

Zhao Zhihua, Yin Yuhui, Zhang Jing, Qi Jingwen, Zhang Dandan, Ma Yihui, Wang Yuhao, Li Shenglei, Zhou Jun

机构信息

Department of Pathology, The First Affiliated Hospital of Zhengzhou UniversityZhengzhou, China; Basic Medicine College of Zhengzhou UniversityZhengzhou, China.

出版信息

Int J Clin Exp Pathol. 2015 Nov 1;8(11):13814-20. eCollection 2015.

Abstract

Spindle cell/sclerosing rhabdomyosarcoma is a rare skeletal-muscle tumor with distinctive clinicopathologic characteristics. 10 cases (6 cases of spindle cell rhabdomyosarcoma and 4 cases of scleroisng rhabdomyosarcoma) were composed of 6 males and 4 females aging from 5 months to 57 years, with median age 33 years, most of who represented a painless solid mass. Histologically, the tumors were composed of fascicles of spindle cells or primitive round cells embed in sclerotic matrix with presence of rhabdomyoblasts in varying proportion. Immunohistochemically, the tumor cells expressed MyoD1 (10/10), Desmin (10/10), myogenin (6/10), AE1/AE3 (2/10), EMA (2/10), but were negative for SMA, caldesmon, S-100. All of the patients underwent a complete surgical resection without or with chemotherapy (2/10) or radiotherapy (1/10). During the follow-up period (1 to 24 months), 1 patient was succumbed, and 2 cases showed in situ recurrence with 1 of them adopting metastasis. Our cases further demonstrate there do present some clincopathologic relations between spindle cells rhabdomyosarcoma and sclerosing rhabdomyosarcoma, but the latter seems to have a better prognosis. Exact grading and staging contribute to predict the outcome.

摘要

梭形细胞/硬化性横纹肌肉瘤是一种罕见的骨骼肌肿瘤,具有独特的临床病理特征。10例患者(6例梭形细胞横纹肌肉瘤和4例硬化性横纹肌肉瘤),其中男性6例,女性4例,年龄从5个月至57岁,中位年龄33岁,大多数表现为无痛性实性肿块。组织学上,肿瘤由梭形细胞束或原始圆形细胞组成,包埋于硬化基质中,不同比例存在横纹肌母细胞。免疫组化方面,肿瘤细胞表达MyoD1(10/10)、结蛋白(10/10)、肌生成素(6/10)、AE1/AE3(2/10)、EMA(2/10),但平滑肌肌动蛋白、钙调蛋白、S-100呈阴性。所有患者均接受了完整的手术切除,部分患者未接受或接受了化疗(2/10)或放疗(1/10)。在随访期(1至24个月),1例患者死亡,2例原位复发,其中1例发生转移。我们的病例进一步证明梭形细胞横纹肌肉瘤和硬化性横纹肌肉瘤之间确实存在一些临床病理关系,但后者似乎预后较好。准确的分级和分期有助于预测预后。

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