淋巴结外指状突树突状细胞肉瘤/肿瘤临床病理观察

摘要

Objective To evaluate the extranodular finger-like protrusion of dendritic cell sarcoma/tumor clinicopathologic features and differential diagnosis to improve the diagnosis of the tumor.Methods For one case occurred in the transverse mesocolon lymph nodes outside the finger-like protrusion of dendritic cell sarcoma/tumor,light microscopy and immunohistochemistry,electron microscopy,and flow cytometry observations were made.Results As for light microscopy,the tumor cells were composed of bundle shaped spindle-shaped,oval cells and small lymphocytes,with unclear boundaries,slightly eosinophilic cytoplasm,spindle-shaped or oval nucleus,a clear nuclear membrane.Chromatin was finely granular,with visible nucleoli.As for immunohistochemistry:S-100,CD68 were positive,SMA,CD20,CD23 focally positive,CD21,CD45RO,CD34,CD117,EMA,CK negative,20%of Ki67 tumor cells positive.As for flow cytome-try,Go/G1(+),G2(+),S(+)prompted for cancer,with a strong cell proliferation response.As for electron microscopy,the tumor cells had a complex finger-like processes,scattered lysosomes,without Birbeck granules.Conclusion Finger-like protrusion of dendritic cell sarcoma/tumor is a rare malignant tumor.Differential diagnosis requires the use of immunohistochemistry,electron microscopy,and flow cytometry.%目的 探讨淋巴结外指状突树突状细胞肉瘤/肿瘤的临床病理学特征及鉴别诊断.方法 对1例发牛在横结肠系膜的淋巴结外指状突树突状细胞肉瘤/肿瘤进行光镜检查和免疫组化、电镜、流式细胞观察.结果 光镜检查,肿瘤细胞由束状、编织状排列的胖梭形、卵圆形细胞和混杂的小淋巴细胞组成,界线不清,胞质略嗜酸性,核呈梭形或卵圆形,核膜清楚,染色质呈细颗粒状,可见核仁.免疫组化:S-100、CD68阳性,SMA、CD20、CD23灶性阳性,CD21、CD45RO、CD34、CD117、EMA、CK阴性,Ki67肿瘤细胞20%阳性.流式细胞:G0/G1(+)、G2(+)、S(+)提示为肿瘤,反应细胞增殖活性较强.电镜:肿瘤细胞具有复杂的指状突起,可见散在溶酶体,无Birbeck颗粒.结论 指状突树突状细胞肉瘤/肿瘤是一种罕见的恶性肿瘤,鉴别诊断需借助免疫组化、电镜及流式细胞术.