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目的报道3例胃原发性癌肉瘤并探讨其临床病理特征,诊断与鉴别诊断。方法对3例胃原发性癌肉瘤进行光镜观察、免疫组化标记并复习相关文献。结果镜下肿瘤主要由癌和肉瘤两种成分构成。癌成分为腺癌,其中1例伴有鳞状分化及神经内分泌分化,免疫组化CK、EMA和CK20(+);肉瘤成分为弥漫分布的梭形细胞,局部区域有横纹肌肉瘤和骨肉瘤分化,免疫组化vimentin、desmin和myoglobin(+),局灶性EMA(+)。结论胃原发性癌肉瘤是一种极其罕见的肿瘤,恶性程度较高,预后较差。免疫组化染色对诊断及鉴别诊断很有帮助。
Objective To report three cases of primary gastric carcinosarcoma and to investigate its clinical and pathological features, diagnosis and differential diagnosis. Methods Three cases of primary gastric carcinosarcoma were observed by light microscopy, immunohistochemically labeled and reviewed. The results of microscopic tumor mainly composed of two components of cancer and sarcoma. One of them had squamous differentiation and neuroendocrine differentiation, immunohistochemical CK, EMA and CK20 (+). The sarcoma consisted of diffusely distributed spindle cells with local rhabdomyosarcoma and osteosarcoma differentiation , Immunohistochemistry vimentin, desmin and myoglobin (+), focal EMA (+). Conclusions Stomach primary carcinosarcoma is an extremely rare tumor with high malignancy and poor prognosis. Immunohistochemical staining for diagnosis and differential diagnosis is helpful.