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摘要: 回顾分析2例原发性肺滑膜肉瘤(PPSS)患者, 病程均较短,胸部CT示:肺部肿块,边界清楚,密度分布不均匀,增强扫描呈不均匀强化。病理结果:可见密集增生的梭形细胞,胞浆少,核浆比升高,染色质细腻,核仁不明显,可见核分裂像。免疫组化:上皮细胞膜抗原、波形蛋白、CD99、细胞角蛋白(+),CD34、Actin、S100、Desmin(-),Ki67局部(+)。基因检测:SS18基因断裂检测(FISH法)阳性。结合胸部CT、病理、免疫组化及融合基因检查可提高对PPSS的诊断水平。
关键词: 肉瘤,  , 滑膜 , 肺, 胸部CT, 病理特征, 免疫组织化学, 融合基因
Abstract: A retrospective study was performed in 2 cases of primary pulmonary synovial sarcoma (PPSS) with short course of the disease. Chest CT scan showed that the lung mass had the characteristics of definite boundaries, uneven density distribution, and heterogeneous enhancement on CT enhanced scan. Pathological examination showed the dense proliferation of spindle cells with less cytoplasm, higher nucleoplasmic ratio, fine chromatin, inconspicuous nucleoli, and mitotic figure. Immunohistochemistry revealed that the cells were positive for epithelial membrane antigen(EMA), vimentin, CD99 and CK, negative for CD34, Actin, S100 and Desmin, and partially positive for Ki67. Cytogenetics showed SS18 gene fragmentation test (FISH method) was positive. Conclusively, the diagnostic level of PPSS can be improved with the combination of chest CT sacn, pathological examination, immunohistochemistry and the examination of fusion gene.
Key words: sarcoma, synovial, lung; , chest ct scan; , pathological features, immunohistochemistry, fusion gene
张学培, 李建国. 原发性肺滑膜肉瘤2例并文献复习[J]. 临床荟萃, doi: 10.3969/j.issn.1004-583X.2019.03.016.
Zhang Xuepei, Li Jianguo. Primary pulmonary synovial sarcoma: report of 2 cases and literature review[J]. Clinical Focus, doi: 10.3969/j.issn.1004-583X.2019.03.016.
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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2019.03.016
https://huicui.hebmu.edu.cn/CN/Y2019/V34/I3/276