Watanabe K, Hiraki H, Ohishi M, Mashiko K, Saginoya H, Suzuki T
Department of Pathology, Fukushima Medical College, Jusendoh General Hospital, Japan.
Pathol Int. 1996 Sep;46(9):656-60. doi: 10.1111/j.1440-1827.1996.tb03668.x.
A 56 year old woman presented with abnormal uterine bleeding. Except for a myomatous uterus, no other abnormalities were noted on physical examination and in radiographic and serologic studies. The hysterectomy specimen revealed an 8 cm uterine fundic tumor composed of two histologically different patterns that merged with one another; one was a well differentiated leiomyosarcoma and the other a mixture of osteoclast-like giant cells (OGC) and plump spindle cells whose cell borders blended, resembling the histology of giant cell tumor of bone. Immunohistochemical studies showed positive staining for muscle actin, alpha-smooth muscle actin, and KP-1 (CD68) in both the spindle cells and OGC. The latter also stained for alpha-1-antitrypsin and alpha-1-antichymotrypsin. These findings suggested that OGC may be formed by the fusion of spindle cells of leiomyosarcoma and also express histiocytic markers.
一名56岁女性因子宫异常出血就诊。体格检查、影像学检查及血清学检查除发现子宫肌瘤外，未发现其他异常。子宫切除标本显示一个8cm的子宫底部肿瘤，由两种组织学不同的模式相互融合组成；一种是高分化平滑肌肉瘤，另一种是破骨细胞样巨细胞（OGC）和丰满梭形细胞的混合物，其细胞边界融合，类似于骨巨细胞瘤的组织学表现。免疫组织化学研究显示，梭形细胞和OGC中肌动蛋白、α-平滑肌肌动蛋白和KP-1（CD68）均呈阳性染色。后者对α-1-抗胰蛋白酶和α-1-抗糜蛋白酶也呈阳性染色。这些发现提示OGC可能由平滑肌肉瘤的梭形细胞融合形成，并表达组织细胞标志物。
