Ebert W
Zentralbl Allg Pathol. 1978;122(4):341-6.
The occurrence of leiomyosarcoma was demonstrated in a tissue cylinder obtained by liver biopsy in a 68-year-old woman with unclear hepatomegaly. The patient died 8 months after she had experienced first signs of illness. Autopsy revealed a primary leiomyosarcoma of the liver with metastases in the lungs, bilaterally in the pleura, in the kidneys, and in the periportal and spleno-pancreatic lymph nodes. The occurrence of a primary tumour in the urogenital system or in the gastrointestinal-tract could be excluded. The diagnosis of leiomyosarcoma was based on the microscopical demonstration of smooth muscle fibres with enlarged red-like and partially atypical cell nuclei and atypical mitoses. Furthermore, we observed extensive necroses and haemorrhagia in the tumour tissue. Preexisting tumours of the liver as, e.g., teratoma or hepatoblastoma were not found. No cirrhosis of the liver could be detected. Obviously, the leiomyosarcoma had its origin in the smooth muscle fibres of the liver vascular system.--According to the literature primary leiomyosarcomas in the liver are only rarely found.
在一名68岁肝脏肿大原因不明的女性患者中,经肝脏活检获取的组织圆柱证实发生了平滑肌肉瘤。该患者在出现最初症状8个月后死亡。尸检显示肝脏原发性平滑肌肉瘤,伴有肺、双侧胸膜、肾脏以及门静脉周围和脾胰淋巴结转移。可排除泌尿生殖系统或胃肠道原发性肿瘤。平滑肌肉瘤的诊断基于显微镜下显示的平滑肌纤维,其细胞核呈肿大的红色样且部分为非典型性,还有非典型性有丝分裂。此外,我们在肿瘤组织中观察到广泛的坏死和出血。未发现肝脏先前存在的肿瘤,如畸胎瘤或肝母细胞瘤。未检测到肝硬化。显然,平滑肌肉瘤起源于肝脏血管系统的平滑肌纤维。——根据文献,肝脏原发性平滑肌肉瘤极为罕见。