【摘要】 目的分析原发及其复发的肝未分化肉瘤的临床和病理变化,明确其组织学特点及复发后的病理改变。方法结合文献,对1例罕见的肝未分化肉瘤的原发及其3次复发病例进行临床及病理形态分析,用S-P法进行免疫组化研究。结果肝未分化肉瘤无特殊的临床表现;影像学改变多为囊性或囊实混合性;组织学图象是由梭形和上皮样的原始间叶细胞、多核巨细胞、PAS阳性的嗜酸小体组成,免疫组化显示Vimentin(+),AACT(+),Desmin(+),Actin(+)。在原发性肿瘤中出现了腺体结构,而在其3次复发的病例中,未见到腺体。结论警惕肝囊性或囊实混合性病变;肝未分化肉瘤内的腺体成分可能是肝胆管的残留和反应性增生;肿瘤可向平滑肌、横纹肌及纤维组织细胞分化。更多还原

【Abstract】 [Objective] To analyse the clinical and pathological changes of a case of primary undifferentiated sarcoma of the liver (USL) and 3 cases of recurrent tumors. [Methods] A case of primary USL and 3 cases of recurrent tumors were observed on histologic features and immunohischemical staining by S-P technique. [Results] The radiographs showed a multicystic or a kind of cystic and solid lesion in USL. Histologically, the primary and its 3 recurrent tumor cells all consisted of the epithelioid and spindle cells and multinucleated giant cells, containing PAS positive bodies. Immunohistochemically, the tumor cells were positive for vimentin, AACT, desmin and actin, but negative for CK and AFP. The glands appeared in the primary tumor, but not in its 3 recurrent ones. [Conclusions] USL should be taken into consideration in any differential diagnosis of cystic hepatic tumor; the glands were the bile duct residua or hyperplasia; the tumor can multidifferentiated to the smooth muscle, skeletal muscle, fibrous histiocyte.更多还原