de Jong A S, van Kessel-van Vark M, Albus-Lutter C E
Hum Pathol. 1987 Mar;18(3):298-303. doi: 10.1016/s0046-8177(87)80013-8.
Pleomorphic rhabdomyosarcoma in adults over 30 years of age was a diagnosis frequently made in the 1960s and 1970s. Since the general acceptance of malignant fibrous histiocytoma (MFH) as a tumor entity at the end of the 1970s, however, it has become a very rare tumor in adults. Therefore, 21 cases originally diagnosed on the basis of histology and clinical data as pleomorphic rhabdomyosarcoma in the 1960s and 1970s were reexamined immunohistochemically. Other types of pleomorphic sarcomas involved in the differential diagnosis were also studied. Specific antibodies against vimentin, desmin, creatine kinase subunit M, skeletal muscle actin and myosin, and myoglobin, and the avidin-biotin-peroxidase complex technique were used. The immunohistochemical findings indicate that rhabdomyosarcoma occurs only rarely in adults over 30 years of age and that the majority of the tumors have to be reclassified as MFH or leiomyosarcoma. On the other hand, several pleomorphic sarcomas were found to be diagnosed incorrectly as MFH or liposarcoma by routine histologic stains and electron microscopy. The revised diagnosis was pleomorphic rhabdomyosarcoma for one case and pleomorphic leiomyosarcoma for the other cases. Thus, this study clearly shows the usefulness of immunohistochemistry as a technique in the diagnosis of pleomorphic sarcomas in adults.
30岁以上成人的多形性横纹肌肉瘤在20世纪60年代和70年代是一种常被诊断出的疾病。然而，自20世纪70年代末恶性纤维组织细胞瘤（MFH）被普遍认可为一种肿瘤实体以来，它在成人中已成为一种非常罕见的肿瘤。因此，对20世纪60年代和70年代最初根据组织学和临床资料诊断为多形性横纹肌肉瘤的21例病例进行了免疫组化复查。还研究了鉴别诊断中涉及的其他类型的多形性肉瘤。使用了针对波形蛋白、结蛋白、肌酸激酶亚基M、骨骼肌肌动蛋白和肌球蛋白以及肌红蛋白的特异性抗体，以及抗生物素蛋白-生物素-过氧化物酶复合物技术。免疫组化结果表明，横纹肌肉瘤在30岁以上成人中很少发生，大多数肿瘤必须重新分类为MFH或平滑肌肉瘤。另一方面，发现一些多形性肉瘤通过常规组织学染色和电子显微镜被错误地诊断为MFH或脂肪肉瘤。其中1例经修订诊断为多形性横纹肌肉瘤，其他病例为多形性平滑肌肉瘤。因此，本研究清楚地表明了免疫组化作为一种技术在诊断成人多形性肉瘤中的有用性。
