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假肉瘤性病变是指形态似肉瘤的非肉瘤性病变,既可为良性病变,也可为恶性病变(如肉瘤样癌、梭形细胞恶性黑色素瘤等)。本文主要讨论的是软组织反应性病变,以间叶细胞增生(主要为继发性纤维母细胞或肌纤维母细胞,偶为骨母细胞)和/或伴有退行性变(核不典型、畸形和分叶核)为主要特征的假肉瘤性病变的病理诊断。此类病变可在各种不同致病因素作用下(炎症、外伤、缺血、电离辐射等)引起假肉瘤性改变,其组织结构和生长迅速、浸润性生长、易见核分裂象等特点,极易误为软组织肉瘤。且此类病变病种多,亚型多,命名繁乱,给病理诊断带来了极大的困难。故掌握其病理形态学特点,以避免过度诊断或诊断不足具有重要意义。
Pseudosarcomatous lesions are non-sarcomasous lesions that resemble sarcomas. They can be either benign lesions or malignant lesions (such as sarcomatoid carcinoma, spindle cell malignant melanoma, etc.). This article focuses on soft-tissue reactive lesions, with mesenchymal hyperplasia (mainly secondary fibroblasts or myofibroblasts, occasionally as osteoblasts) and/or with degenerative changes (nuclear asymmetry, malformation, and The lobular nucleus) is the main feature of the pathological diagnosis of pseudosarcomatous lesions. These lesions can cause pseudosarcomatous changes under the influence of various pathogenic factors (inflammation, trauma, ischemia, ionizing radiation, etc.), and their tissue structure and rapid growth, invasive growth, easy to see mitotic figures, etc. Easy to mistake for soft tissue sarcoma. In addition, there are many kinds of such lesions, many subtypes, and complicated names, which brings great difficulties to pathological diagnosis. Therefore, it is of great significance to master its pathomorphological features to avoid overdiagnosis or underdiagnosis.