摘要:目的：探討皮膚平滑肌肉瘤的臨床病理特點(diǎn)和診斷要點(diǎn)及預(yù)后。方法:對2例皮膚平
滑肌肉瘤組織病理學(xué)、免疫組化觀察,并復(fù)習(xí)相關(guān)文獻(xiàn)。結(jié)果: 例1為皮下平滑肌肉瘤,具有結(jié)節(jié)型的生長形態(tài),瘤細(xì)胞豐富,異型性較大,核分裂活躍；例2為真皮平滑肌肉瘤,具有彌漫型的生長形態(tài),瘤細(xì)胞較少,分化好,核分裂象不明顯。免疫組化2例均表達(dá)SMA、MSA、Vim,1例灶性表達(dá)Desmin。2例隨訪迄今均無復(fù)發(fā)及轉(zhuǎn)移。結(jié)論:皮膚平滑肌肉瘤少見,可分為真皮和皮下兩種類型,兩者具有不同的組織起源和預(yù)后特點(diǎn),我們要注意區(qū)分,診斷除核分裂象計(jì)數(shù)外,尚需進(jìn)行綜合評估,對某些病例建議采用惡性潛能未定的平滑肌肉瘤的診斷,治療首選外科手術(shù)切除。
Abstract: Objective: To investigate the clinic pathological features diagnosis main point and prognosis of cutaneous leiomyosarcoma（CLMS）.Methods:Histopatho
logy,immunohistochemical stainings observation were analyzed in two cases of CL
MS and the related literatures were reviewed. Results:Case 1 was subcutaneous l
eiomyosarcoma with tubercular growth pattern,rich tumor cell,big heterogeneous type,active mitotic；Case 2 was dermis leiomyosarcoma with diffuse growth pattern,few tumor cell,well differentiated,no more mitotic. Immunohistochemically,the two cases reacted positively with smooth muscle action、MSA and Vim,Case 1 also expressed desman partially. The two cases were revisited to date,no recurrences and metastases.Conclusion:Cutaneous leiomyosar coma is a rare tumor,subdivided into dermis and subcutaneous forms because of their different tissue origins and prognosis features. We must discriminate between them. Diagnosis need synthetic appraisal besides mitotic counts and “smooth muscle tumor of uncertain malignant potential” should be used for diagnosis of certain cases.Primary treatment for cutaneous leiomyosarcoma is surgical excision.

引用本文： 王西川,廖嘉煦,吳蓉宜. 皮膚平滑肌肉瘤2例臨床病理分析. 華西醫(yī)學(xué), 2009, 24(12): 3142-3144. doi: 復(fù)制

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