【摘要】 目的:探讨下肢上皮样血管内皮瘤诊断、鉴别诊断、治疗及误诊原因。方法:分析下肢上皮样血管内皮瘤临床表现、组织病理学和免疫组化特征,讨论其诊断、鉴别诊断和治疗等。结果:下肢原发性上皮样血管内皮瘤在术前误诊为假性动脉瘤,术中发现为血供丰富之实性肿瘤,予扩大切除。组织病理学提示肿瘤细胞呈梭形上皮样,核分裂不明显。免疫组化染色显示F、CD34、CD31、vimentin阳性;而SMA、CK、S-100、desmin蛋白阴性,证实为上皮样血管内皮瘤。结论:上皮样血管内皮瘤诊断依靠组织病理学和免疫组化,需与假性动脉瘤、转移性癌、血管肉瘤等鉴别。因其有潜在恶性,故治疗以局部扩大切除为主。更多还原

【Abstract】 Objective:To discuss the diagnosis,differential diagnosis,therapy and misdiagnosis reasons on epithelioid hemangioendothelioma on lower extremity.Methods:The clinical data,histopathology and immunohistochemistry character of primary epithelioid hemangioendothelioma on lower extremity were reviewed;and its diagnosis,differential diagnosis and therapy were investigated.Results:The case of primary epithelioid hemangioendothelioma on lower extremity was misdiagnosed as pseudoaneurysm pre-operation which was identified substantial tumor with massive blood supply in operation.Histopathological examination revealed the epithelioid tumor cells were spindle shape without obvious karyoschisis.It was identified positive of FⅧ,CD34,CD31 and vimentin with histochemistry study;and negative of SMA,CK,S-100 and desmin.Conclusion:Epithelioid hemangioendothelioma should be diagnosed with histopathological and immunohistochemistry method.It′s needed to be differentially diagnosed with pseudoaneurysm,metastatic carcinoma,angiosarcoma,and so on.Local extended resection is the principal therapy for its potential malignancy.更多还原