【摘要】 目的探讨多形性未分化肉瘤复发为骨外骨肉瘤的临床病理特征及两种类型肿瘤的组织病理学及免疫表型的异同点。方法报道1例同一个患者在2年内腹部出现两种不同类型肿瘤的形态学表现,对两次病程的临床特点、光镜形态和免疫组化进行分析。结果患者女性,78岁。2011年于外院行左腹部肿瘤摘除术,术后病理诊断为多形性未分化肉瘤。近期患者因肿物复发在本院手术,从近回盲部小肠壁浆膜侧和左上腹腹膜后各切取肿物1枚。术后病理诊断为骨外骨肉瘤。免疫组化:两类型肿瘤SMA均(+),多形性未分化肉瘤强于骨肉瘤;Ki-67在两种类型肿瘤中阳性指数为20%和65%。结论这两种间叶成分来源的肿瘤可以互相转化,恶性程度增加。更多还原

【Abstract】 Objective To investigate the clinical and pathological features of an undifferentiated pleomorphic sarcoma recrudesced and transformed into an extraskeletal osteosarcoma. Methods We compared the clinical and pathological differences between the undifferentiated pleomorphic sarcoma and the extraskeletal osteosarcoma through microscopy and immunohistochemical staining of the tumor tissue sections. Results A 78 years old female patient presented a tumor mass from the left abdomen in 2011,and the pathological diagnosis was undifferentiated pleomorphic sarcoma. However,this patient had to be operated again two years later because of the tumor recurrence. The surgeons cutted off two tumors from left abdominal retroperitoneum and the small intestine serosal side near the ileocecal portion,respectively. The pathological diagnosis of these tumors was extraskeletal osteosarcoma,which was supported by immunohistochemistry and morphological features. SMA was expressed in both types of sarcomas,but the expression density of undifferentiated pleomorphic sarcoma was stronger than that of osteosarcoma. And the expression ratio of Ki-67 in these two types of sarcomas was 20% vs 65%. Conclusions The undifferentiated pleomorphic sarcoma is able to relapse and transform into extraskeletal osteosarcoma with an increased degree of malignancy.更多还原