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目的探讨滑膜软骨肉瘤的临床病理特点及鉴别诊断要点。方法对1例滑膜软骨肉瘤进行临床病理观察并行免疫组化标记。结果肿瘤位于关节腔内,呈不规则分叶状;切面灰白、灰蓝色,质脆,部分区域灰红色、质软。镜下见软骨细胞片状分布,伴有细胞不典型性;大部分区域软骨细胞分化较差,呈梭形,核仁大而明显,可见双核、大核及异型核的肿瘤细胞,局灶坏死明显,病理性核分裂多见。免疫组化:S-100和vimentin(+)。结论滑膜软骨肉瘤非常罕见,临床上主要应与滑膜软骨瘤病及色素沉着绒毛结节性滑膜炎等鉴别,组织学上可分为原发型和继发型,确诊需结合临床病史、影像学、手术所见及组织学形态综合判断分析。
Objective To investigate the clinicopathological features and differential diagnosis of synovial chondrosarcoma. Methods One case of synovial chondrosarcoma was observed clinically and pathologically and immunohistochemically. Results The tumor was located in the joint cavity with irregular lobulation. The cut surface was gray, grayish blue and crisp, and the area was gray-red and soft. Chondrocytes flaky distribution, with atypia; most of the area of poorly differentiated chondrocytes, spindle-shaped, large and obvious nucleoli, showing the dual-nuclei, nuclear and abnormal nuclear tumor cells, focal necrosis Obviously, pathological mitosis more common. Immunohistochemistry: S-100 and vimentin (+). Conclusions Synovial chondrosarcoma is very rare and should be mainly differentiated from synovial chondromatosis and pigmented villonodular synovitis in clinic. Histologically, it can be divided into primary type and secondary type. The diagnosis should be based on clinical history, Imaging, surgical findings and histological analysis of comprehensive judgment.