Suster S, Wong T Y, Moran C A
Arkadi M. Rywlin Department of Pathology and Laboratory Medicine, Mount Sinai Medical Center, Miami Beach, FL 33140.
Am J Surg Pathol. 1993 Sep;17(9):905-11. doi: 10.1097/00000478-199309000-00006.
Two cases are described of a soft-tissue sarcoma characterized histologically by the intimate admixture of areas displaying the features of liposarcoma and leiomyosarcoma. Both cases occurred in men, 70 and 77 years of age. The lesions were located in the left scrotum and abdominal cavity, respectively. Histologically, the lipomatous component in both cases consisted predominantly of well-differentiated liposarcoma with myxoid areas. The smooth-muscle component was characterized by intersecting fascicles of spindle cells displaying nuclear atypicality and scattered mitotic figures; the spindle cells in these areas were strongly immunoreactive with actin and desmin antibodies. The above tumors must be distinguished from angiomyolipoma, spindle-cell lipoma, myolipoma of soft tissue, and more importantly, from "dedifferentiated" liposarcoma. The development of dual lineage differentiation within adipose tissue tumors as exemplified by these two cases may be more prevalent than has been generally recognized, and may require the application of immunohistochemical markers for specific identification of the spindle-cell component.
本文描述了两例软组织肉瘤，其组织学特征为同时存在显示脂肪肉瘤和平滑肌肉瘤特征的区域。两例均发生于男性，年龄分别为70岁和77岁。病变分别位于左侧阴囊和腹腔。组织学上，两例中的脂肪瘤样成分主要由伴有黏液样区域的高分化脂肪肉瘤组成。平滑肌成分的特征为梭形细胞束相互交叉，显示核异型性并伴有散在的有丝分裂象；这些区域的梭形细胞对肌动蛋白和结蛋白抗体呈强免疫反应性。上述肿瘤必须与血管平滑肌脂肪瘤、梭形细胞脂肪瘤、软组织肌脂肪瘤相鉴别，更重要的是要与“去分化”脂肪肉瘤相鉴别。以这两例为例，脂肪组织肿瘤内双谱系分化的发生可能比普遍认为的更为常见，可能需要应用免疫组化标记物来特异性鉴定梭形细胞成分。
