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目的探讨心脏原发性未分化多形性肉瘤的病理学特征、诊断与鉴别诊断。方法应用光镜和免疫组化染色,对1例原发于心脏的未分化多形性肉瘤进行观察,同时复习相关文献并进行讨论。结果镜下肿瘤细胞排列成编织状,细胞大小不一,形态多样,呈圆形、梭形或上皮样,有丰富的嗜酸性胞质;间质见慢性炎细胞浸润,混有纤维母细胞及平滑肌样细胞,巨细胞散在。瘤细胞核仁明显,染色质粗颗粒状,核分裂象多见。免疫组化:肿瘤细胞vimentin、α1-AT、actin和lysozyme(+),myogenin、CK19和S-100(-)。结论未分化多形性肉瘤是原发于心脏的恶性肿瘤中极为罕见的肿瘤,需要与横纹肌肉瘤、纤维肉瘤、血管肉瘤等鉴别。治疗以手术加局部放疗、化疗为主。
Objective To investigate the pathological features, diagnosis and differential diagnosis of primary undifferentiated pleomorphic sarcoma in the heart. Methods One case of undifferentiated pleomorphic sarcoma in the heart was observed by light microscopy and immunohistochemical staining, and the related literatures were reviewed and discussed. Results The tumor cells were arranged in a braided shape with different cell sizes and various shapes. They were round, fusiform or epithelial and rich in eosinophilic cytoplasm. Interstitial infiltration of chronic inflammatory cells was observed with fibroblasts and fibroblasts Smooth muscle-like cells, giant cells scattered. Tumor cells have obvious nucleoli, coarse granular chromatin, mitotic common. Immunohistochemistry: tumor cells vimentin, α1-AT, actin and lysozyme (+), myogenin, CK19 and S-100 (-). Conclusion Undifferentiated pleomorphic sarcoma is a very rare tumor in primary malignant tumors of the heart and needs to be differentiated from rhabdomyosarcoma, fibrosarcoma and angiosarcoma. Treatment plus local radiotherapy, chemotherapy-based.