Brathwaite C D, Poppiti R J
Arkadi Rywlin Department of Pathology and Laboratory Medicine, Mount Sinai Medical Center of Greater Miami, FL, USA.
Am J Surg Pathol. 1996 Feb;20(2):233-8. doi: 10.1097/00000478-199602000-00012.
Glomus tumors are characteristically benign solitary tumors. A few cases of malignant glomus tumors have been reported; however, they are usually only locally invasive, and metastases are exceedingly rare. We report a case of widespread metastases of a malignant glomus tumor involving the skin, lungs, jejunum, liver, spleen, and lymph nodes in a 63-year-old man with end-stage chronic renal failure. At autopsy, multiple glomus body hamartomas were also noted throughout the dermis proximal to the skin tumors. Histologically, the tumor was composed of monotonous round cells in solid sheets and investing numerous capillary-sized vessels. Approximately four to six mitoses were present per high-power field. The tumor cells were strongly immunoreactive for actin and vimentin, and ultrastructurally there were whorls of microfilaments with focal condensations. This case is exceptional because of its aggressive course.
血管球瘤通常为良性孤立性肿瘤。虽有少数恶性血管球瘤的病例报道，但它们通常仅局部浸润，转移极为罕见。我们报告一例63岁终末期慢性肾衰竭男性患者，其恶性血管球瘤发生广泛转移，累及皮肤、肺、空肠、肝、脾及淋巴结。尸检时，在皮肤肿瘤近端的整个真皮层也发现了多个血管球错构瘤。组织学上，肿瘤由实性片状排列的单一圆形细胞构成，并包绕许多毛细血管大小的血管。每个高倍视野约有4至6个核分裂象。肿瘤细胞对肌动蛋白和波形蛋白呈强免疫反应，超微结构显示有微丝漩涡伴局灶性浓缩。该病例因其侵袭性病程而罕见。
