Division of Human Pathology, Department of Pathology and Microbiology, Nihon University School of Medicine, 30-1, Oyaguchi Kami-Chou, Itabashi-Ku, Tokyo, 173-8610, Japan.
Department of Orthopaedic Surgery, Nihon University School of Medicine, 30-1, Oyaguchi Kami-Chou, Itabashi-Ku, Tokyo, 173-8610, Japan.
J Med Case Rep. 2024 Aug 16;18(1):373. doi: 10.1186/s13256-024-04693-y.
Myxofibrosarcoma is a myxoid soft tissue sarcoma showing T2 high intensity on magnetic resonance imaging. However, myxofibrosarcoma is a heterogeneous sarcoma with both myxoid and cellular portions. Magnetic resonance imaging findings were obtained MRI findings for comparison with histological and Ki-67 immunohistochemical features, in different portions of one myxofibrosarcoma.
Magnetic resonance imaging observations were compared with gross pathological and microscopic findings of a myxofibrosarcoma from a 50-year-old Japanese female. The Ki-67 labeling indices of different portions of the tumor, that is, the myxoid, cellular, and histologically confirmed infiltrative margin portions (pathological tail sign), were compared. The T2 low intensity area was more cellular than the T2 high intensity area, while the cellular portion had a significantly higher Ki-67 index than the myxoid portion (p = 0.0313). The portions with the pathological tail sign had a significantly higher Ki-67 labeling index than those without this sign (p = 0.0313).
More cellular portions of a myxofibrosarcoma correspond to more areas of the tumor showing aggressive features. Furthermore, our data also support the hypothesis of high aggressiveness being associated with the pathological tail sign in myxofibrosarcoma. To our knowledge, this is the first case report to describe comparisons among the imaging findings, histological features, and Ki-67 immunohistochemistry results for different portions of one myxofibrosarcoma.
黏液纤维肉瘤是一种黏液样软组织肉瘤,在磁共振成像(MRI)上表现为 T2 高信号。然而,黏液纤维肉瘤是一种异质性肉瘤,既有黏液样部分,也有细胞性部分。为了与组织学和 Ki-67 免疫组织化学特征进行比较,我们对同一例黏液纤维肉瘤的不同部位进行了 MRI 检查。
我们对一名 50 岁日本女性的黏液纤维肉瘤的 MRI 观察结果与大体病理和显微镜下发现进行了比较。比较了肿瘤不同部位(黏液样、细胞性和组织学证实的浸润性边缘部分,即病理长尾征)的 Ki-67 标记指数。T2 低信号区比 T2 高信号区更具细胞性,而细胞性部分的 Ki-67 指数明显高于黏液样部分(p=0.0313)。具有病理长尾征的部分的 Ki-67 标记指数明显高于没有此征的部分(p=0.0313)。
黏液纤维肉瘤中更具细胞性的部分对应于具有侵袭性特征的肿瘤更多区域。此外,我们的数据还支持病理长尾征与黏液纤维肉瘤的高侵袭性相关的假说。据我们所知,这是首例描述同一例黏液纤维肉瘤不同部位的影像学表现、组织学特征和 Ki-67 免疫组织化学结果之间比较的病例报告。