摘要
目的:探讨精索恶性纤维组织细胞瘤的临床表现、诊断和治疗方法。方法:回顾性分析2例精索恶性纤维组织细胞瘤的临床资料,并结合文献分析该病临床表现、影像学征象、病理学特点、治疗方法和预后。结果:1例影像学检查考虑为精原细胞瘤,1例考虑为精索肿瘤。光镜下观察,例1短梭形瘤细胞呈疏松筋膜样排列,瘤细胞呈纤维母细胞样。可见散在的异型性明显的瘤巨细胞。例2密集的异型梭形瘤细胞呈筋膜样排列,局部形成模糊的席纹状结构。可见异型性明显的多形性瘤巨细胞。免疫组化染色,2例除表达Vimentin外,均不表达表达S-100,SMA,Desmin,HMB45等标志物。结论:精索恶性纤维组织细胞瘤为罕见肿瘤,组织学形态和免疫组化特点与发生于其他部位者相似。根治性腹股沟睾丸切除术并广泛切除周围软组织是目前推荐的治疗方法,术后辅助性放疗可减少复发。
Objective： To study the clinical manifestation, diagnosis and treatment of malignant fibrous histioeytoma （MFH） of the spermatic cord. Method： The clinical data of two cases of MFH of the spermatic cord were analyzed retrospectively. We reviewed the related literature and analyzed the clinical manifestation, imaging examination, pathological features, treatment and prognosis of MFH of the spermatie cord. Result： Both tumors occurred in elderly men and presented with left inguinal mass. They were diagnosed with seminorna and tumor of the spermatic cord respectively by imaging examination. In the first case, the tumor was composed of short spindleshaped tumor cells similar to fibroblast cells arranged in loose fascicular growth pattern with scattered large pleomorphic tumor cells. In the second case, the atypia spindle-shaped tumor cells arranged in hypercellular fascicular growth pattern with a vague storiform pattern in focal areas and many tumor giant cells were identified. Immuno-histochemically, both tumors showed expression for Vimentin and no expression for S-100, SMA, Desmin, HMB45 and other markers. Conclusion： MFH of the spermatic cord is rare. The histology and immunohistochemical features are similar to MFH in other locations. The current standard therapeutic approach has been radical inguinal orchiectomy with wide resection of surrounding soft tissues. Adjuvant radiotherapy after surgery may reduce tumor recurrence.
出处
《临床泌尿外科杂志》
2015年第12期1083-1085,1088,共4页
Journal of Clinical Urology
关键词
精索
恶性纤维组织细胞瘤
肉瘤
spermatic cord
malignant fibrous histiocytoma
sarcoma
