【摘要】 目的　研究横纹肌肉瘤的形态学 ,阐明诊断和鉴别诊断。方法　分析 40例横纹肌肉瘤的组织类型、形态和免疫组化。结果　分为 3种亚型 ,胚胎型横纹肌肉瘤 2 0例 ,含有星形、梭形和小圆形细胞形 ;腺泡状横纹肌肉瘤16例 ,以小圆形细胞及中圆形细胞为主 ;多形性横纹肌肉瘤 4例 ,多为大圆形及中圆形细胞。全部肿瘤中 ,带状细胞 ,蝌蚪形细胞及多核细胞占 2 7% ,仅 1例见到横纹。免疫组化阳性率分别为 :Vimentin 92 % ,desmin 5 3.3% ,平滑肌肌动蛋白 87.5 %及Myoglobin 92 .2 %。结论　在横纹肌肉瘤中少数为带状及蝌蚪状细胞 ,绝大多数为圆形细胞 ,后者具有重要诊断价值 ,免疫组化能增加诊断的正确性更多还原

【Abstract】 Objective To study morphological features of rhabdomyosarcoma and to elucidate its diagnosis and differential diagnosis. Methods Histologic patterns, morphologic changes and immunohistochemical stainings were analyzed in 40 cases of rhabdomyosarcomas. Results It was divided into three subtypes: 20 cases of embryonal rhabdomyosarcoma (ERMS) consisting of stellate shaped cells, spindle cells and small round cells; 16 cases of alveolar rhabdomyosarcoma (ARMS) showing predominantly small and medium sized round cells; 4 cases of polymorphic rhabdomyosarcoma (PRMS) appearing mostly large and medium sized cells. The strap shaped cells, tadpole shaped cells and multinucleated cells accounted for 27% in all the tumors. Cross striations were founded in all cases but one. Positive rates of immunostainings were: vimentin in 92% cases, desmin 53.3%, smooth muscle actin 87.5% and myoglobulin 92.2% respectively. Conclusion There are less strap and tadpole shaped cells and predominantly round cells in rhabdomyosarcomas, the latter playing an important role in the diagnosis. The immunohistochemical stainings can increase accuracy of the diagnosis.更多还原