髓系肉瘤临床病理分析
| 作者: |
1,2江文辉,
3陈燕坪,
3许春伟,
2龙联文,
3王健超,
3黄榕芳,
3胡丹,
3卢建平,
3何时,
3陈刚
1 福建医科大学附属福建省肿瘤医院病理科，福州 350014 2 龙岩市第二医院病理科，福建 龙岩 364000 3 福建医科大学附属福建省肿瘤医院病理科，福州 350014 |
| 通讯: |
陈刚
Email: naichengang@126.com |
| DOI: | 10.3978/j.issn.2095-6959.2017.10.017 |
| 基金: | 国家临床重点专科建设项目 2013 福建省自然基金青年人才创新项目 2014J05085 |
摘要
目的：探讨髓系肉瘤(myeloid sarcoma，MS)的临床病理学特征、免疫组织化学、鉴别诊断及预后。方法：收集16例MS患者的临床及病理资料，对其组织学形态和免疫表型、分子及预后进行回顾性研究，并分析相关文献。结果：16例MS，男9例，女7例，年龄21~72(平均45)岁，肿瘤呈弥漫片状生长，核圆形、卵圆形、染色质细腻，核分裂易见。免疫组织化学染色可表达抗髓过氧化物酶(myeloperoxidase，MPO)，Lyz，CD43，CD68 (kp-1)和CD117。结论：MS可能有轻微的男性优势，可能发生在任何年龄和身体的任何位置，导致多样化的临床表现及容易误诊。确诊主要依靠病理学形态及免疫组织化学。淋巴恶性肿瘤大剂量治疗的晚期并发症可以出现继发性急性髓性白血病。系统性化疗能够提高患者的总生存期。
关键词：
髓系肉瘤
急性白血病
免疫组织化学
鉴别诊断
治疗
Clinicopathological features of myeloid sarcoma
CorrespondingAuthor: CHEN Gang Email: naichengang@126.com
DOI: 10.3978/j.issn.2095-6959.2017.10.017
Abstract
Objective: To investigate clinicopathological features, immunohistochemistry, differential diagnosis and prognosis of the myeloid sarcoma (MS). Methods: The clinicopathological data, the histological morphology and immunophenotype, molecular and prognosis of 16 patients were retrospectively analyzed and the relevant literatures were reviewed. Results: The age of 16 patients ranged from 21 to 72 years (mean, 45 years). The male to female ratio was 1.3:1. The tumor was diffusely patchy, round and oval, with fine chromatin and karyokinesis were visible. Immunochemistry of myeloperoxidase (MPO), Lyz, CD43, CD68 (kp-1), CD117 were positive. Conclusion: MS may have a slight male predominance and occur at any age and any position of the body, resulting in the diverse clinical manifestations and misdiagnosis. The diagnosis mainly depends on the pathological morphology and immunohistochemistry. Secondary acute myelogenous leukemia (sAML) is well-recognized in the late complications of high-dose therapy for lymphoid malignancies. Systemic chemotherapy can improve overall survival.
Keywords：
myeloid sarcoma
acute leukemia
immunohistochemistry
differential diagnosis
treatment