1 福建医科大学病理学系，福州 350014
2 福建省肿瘤医院病理科，福州 350014
3 龙岩市第二医院病理科，福建 龙岩 364000
目的：探讨未分化多形性肉瘤(undifferentiated pleomorphic sarcoma，UPS)的临床病理学特征、免疫组织化学及鉴别诊断。方法：收集10例UPS患者的临床及病理资料，对其组织学形态和免疫表型及预后进行回顾性研究。结果：在10例UPS患者中，男8例，女2例，男女比为4:1，年龄45~73(平均57.7)岁，肿瘤直径1.5~7.0(平均3.9) cm。肿瘤细胞呈梭形和多形性排列成束状、交织状或席纹状。核分裂易见，可见多核瘤巨细胞及间质多少不等的炎症细胞浸润。免疫组织化学染色显示可表达 Vimentin，CD68，不表达HMB-45，S-100，CKpan，SMA，CD34，Desmin。结论：UPS临床症状无特异性，诊断依赖病理学形态及免疫组织化学。需与胃肠道间质瘤、多形性脂肪肉瘤、多形性平滑肌肉瘤、多形性横纹肌肉瘤、黏液纤维肉瘤、分化差的癌和恶性黑色素瘤相鉴别。关键词： 未分化多形性肉瘤；免疫组织化学；鉴别诊断；治疗
Clinicopathological analysis of undifferentiated pleomorphic sarcoma
CorrespondingAuthor:CHEN Gang Email: email@example.com
Foundation: This work was supported by the Science and Technology Project of Fujian Province, China (2018Y2003).
Objective: To investigated the clinicopathological features, immunohistochemistry and differential diagnosis of undifferentiated pleomorphic sarcoma (UPS). Methods: The clinical and pathological data of 10 patients with UPS were collected. The histological morphology, immunophenotype and prognosis were retrospectively studied. Results: Among the 10 patients with UPS, 8 were male and 2 were female, with a male-to-female ratio of 4:1, age of 45–73 years (average 57.7 years), tumor diameter of 1.5–7.0 cm (average 3.9 cm). Tumor cells were fusiform and pleomorphic in a bundle, interlaced or mat-like shape. Nuclear fission was easy to see, showing multi-nuclear giant cells and interstitial inflammatory cell infiltration. Immunohistochemical staining showed the could expression of Vimentin, CD68, HMB-45, S-100, CKpan, SMA, CD34, Desmin. Conclusion: The clinical symptoms of UPS are non-specific, and the diagnosis depends on pathological morphology and immunohistochemistry. UPS needed to be differentiated from gastrointestinal stromal tumors, pleomorphic liposarcoma, pleomorphic leiomyosarcoma, pleomorphic rhabdomyosarcoma, mucinous fibrosarcoma, poorly differentiated carcinoma, and malignant melanoma.Keywords： undifferentiated pleomorphic sarcoma; immunohistochemistry; differential diagnosis; treatment