【摘要】 目的　研究骨小细胞恶性肿瘤 (SCMT)的病理形态和免疫组化特点。方法　应用免疫组化S P法对 34例SCMT进行组织学观察。结果　 34例SCMT中 2 2例为弥漫型非霍奇金恶性淋巴瘤 ,其中 2 1例B细胞性 ,1例T细胞性 ;瘤组织表达CD4 5 (LCA)、CD2 0 (L2 6 )或CD4 5RO(UCHL 1)。 7例浆细胞肿瘤 ,其中 5例为多发性骨髓瘤、2例为孤立性浆细胞瘤 ,表现为单一的不同分化程度的肿瘤性浆细胞 ;免疫组化示 6例CD38(+)。 2例Ewing肉瘤显示排列密集、大小较一致的圆形细胞 ;肿瘤表达CD99和Vim。 1例小细胞骨肉瘤 ,肿瘤由丰富密集的小细胞和网格状的骨样组织组成 ,瘤细胞Vim阳性。 1例间叶性软骨肉瘤示富于血管的圆形或梭形细胞和透明软骨 ;瘤细胞表达Vim ,软骨细胞表达S 10 0蛋白。 1例小细胞癌示小细胞紧密片巢状排列 ,表达CK和EMA。结论　骨SCMT组织学类型各有不同的病理形态和免疫组化特征 ,结合临床和X线表现可作出正确的病理诊断更多还原

【Abstract】 Purpose To study pathomorphological and immunohistochemical characteristics of small cell malignant tumor(SCMT) of bone. Methods Thirty four cases of SCMT were analysed by using histological observation combined with immunohistochemical detection. Results In 34 cases of SCMT, 22 were diffuse non Hodgkin’s malignant lymphoma with 21 B cell type and 1 T cell type, and all tumor cells expressed CD45(LCA), CD20(L26) or CD45RO(UCHL 1) immunohistochemically. Seven cases were plasmacyte tumor in which 5 were multiple myeloma and 2 were solitary plasmacytoma, all tumor cells were neoplastic plasmacytes in different developmental stages and immunohistochemically 6 expressed CD38. Two cases were Ewing’s sarcoma, in which histologically tumor round cells with identical size and compact arrangement, and expressed CD99 and Vim. One case was small cell osteosarcoma with network of osteoid tissues in stroma and expressed Vim immunohistochemically. One case was mesenchymal chondrosarcoma showing round or spindle tumor cells with stroma of rich blood vessels and hyaline cartilage , the tumor cells expressed Vim and chondrocytes S 100 protein. One case of small cell carcinoma showing small cells tightly arranged in sheets or nests immunohistochemically expressed CK and EMA. Conclusions Every type of SCMT in bone has its unique histopathological and immunohistochemical charactristics. By using the characteristics and combining with clinical and X ray findings, can make a correct pathological diagnosis.更多还原