Wright E P, Glick A D, Virmani R, Page D L
Am J Surg Pathol. 1985 Dec;9(12):890-7. doi: 10.1097/00000478-198512000-00005.
A 46-year-old woman died from massive bowel infarction. At autopsy, a primary sarcoma was found growing along the intimal surface of the aorta at the level of the celiac axis. Tumor emboli were found in distal aortic branches and most abdominal organs. Immunoperoxidase for Factor VIII and electron microscopy (EM) did not support an endothelial origin. EM showed myofibroblastic differentiation. Review of the literature yields an array of diagnostic histologic terms for these tumors, hampering case comparison. The literature does suggest, however, that the clinical presentation of these rare neoplasms correlates nicely with the location and gross morphology of the lesion. We therefore propose a clinicopathologic classification, categorizing the lesions as intimal (obstructive and nonobstructive) and mural. The former are typically pleomorphic sarcomas and are probably of myofibroblastic origin, whereas the latter are usually leiomyosarcomas or fibrosarcomas that probably originate in the media or adventitia.
一名46岁女性死于大面积肠梗死。尸检时，在腹腔干水平的主动脉内膜表面发现一个原发性肉瘤。在主动脉远端分支和大多数腹部器官中发现了肿瘤栓子。因子VIII免疫过氧化物酶检测和电子显微镜检查（EM）不支持内皮起源。EM显示肌成纤维细胞分化。文献回顾发现这些肿瘤有一系列诊断性组织学术语，这妨碍了病例比较。然而，文献确实表明，这些罕见肿瘤的临床表现与病变的位置和大体形态密切相关。因此，我们提出一种临床病理分类，将病变分为内膜型（阻塞性和非阻塞性）和壁层型。前者通常是多形性肉瘤，可能起源于肌成纤维细胞，而后者通常是平滑肌肉瘤或纤维肉瘤，可能起源于中膜或外膜。
