Myofibroblastic differentiation in malignant fibrous histiocytoma (pleomorphic myofibrosarcoma): a clinicopathological study
Myofibroblastic differentiation in malignant fibrous histiocytoma (pleomorphic myofibrosarcoma): a clinicopathological study
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DOI：
10.1046/j.1365-2559.2001.01152.x
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发表时间：
2001-06-01
期刊：
影响因子：
6.4
通讯作者：
Fisher, C
中科院分区：
文献类型：
--
作者：
Montgomery, E;Fisher, C
目的：我们比较了多形性恶性纤维组织细胞瘤（MFH）样软组织肉瘤的临床和病理特征，并没有myofibroblastic分化的电子microscopic.Methods和结果：五十三个软组织肿瘤指定为MFH光镜和电子显微镜进行了重新评估。18例被明确诊断并排除，其他35例病例中有24例获得了随访（FU）信息。电镜下7/24例（29%）可见肌成纤维细胞超微结构，17/24例（71%）缺乏肌成纤维细胞，表现为成纤维细胞或未分化细胞。组织学上，所有的肿瘤，但一个故事状多形性区，一个肌纤维母细胞肿瘤是束状和粘液样。未观察到其他形态学差异。在7例肌纤维母细胞中，平滑肌4例，肌肉特异性肌动蛋白2例，结蛋白3例，S100 1例。在其他15个肿瘤中，平滑肌在5例和肌肉特异性肌动蛋白在1例，结蛋白在1例中存在，这些情况下没有表达S100，CD 34被发现在粘液样区域的一个肌纤维肉瘤和3/15其他肿瘤。bcl-2仅在非肌纤维母细胞肉瘤中表达（4/14）。随访（中位41个月）时，2/7（29%）的肌纤维母细胞肿瘤复发，5/7（71%）转移，3/7（43%）的患者死于疾病。在非肌纤维母细胞肉瘤，平均随访47个月，6/17例（35%）复发，10/17（59%）转移，7/17例（41%）死于diseases.Conclusions：多形性肉瘤与不肌纤维母细胞分化的电子显微镜下的临床和组织学相似。前者显示肌样免疫组化标记更频繁。
Aims: We compared the clinical and pathological features of pleomorphic malignant fibrous histiocytoma (MFH)-like soft tissue sarcomas with and without myofibroblastic differentiation on electron microscopy.Methods and Results: Fifty-three soft tissue tumours designated as MFH by light and electron microscopy were reassessed. Eighteen were specifically diagnosed and excluded, and follow-up (FU) information obtained for 24 of the other 35 cases. Myofibroblastic ultra-structure was seen in 7/24 (29%), Seventeen of 24 (71%) lacked myofibroblasts on electron microscopy, which showed fibroblastic or undifferentiated cells. Histologically, all tumours but one had storiform-pleomorphic areas; one myofibroblastic neoplasm was fascicular and myxoid. No other morphological differences were seen. In seven myofibroblastic cases, smooth muscle in four cases and muscle-specific actin in two cases, desmin in three cases and S100 in one case were present. In 15 other tumours, smooth muscle in five cases and muscle-specific actin in one case, and desmin in one case were present; none of these cases expressed S100, CD34 was found in the myxoid areas of one myofibrosarcoma and 3/15 other tumours. Positivity for bcl-2 was seen only in non-myofibroblastic sarcomas (4/14). On follow-up (median 41 months), 2/7 (29%) myofibroblastic tumours recurred, 5/7 (71%) metastasized, and 3/7 (43%) patients died of disease. Among the non-myofibroblastic sarcomas, with a median follow-up of 47 months, 6/17 cases (35%) recurred, 10/17 (59%) metastasized, and 7/17 patients (41%) died of disease.Conclusions: Pleomorphic sarcomas with and without myofibroblastic differentiation on electron microscopy are clinically and histologically similar. The former display myoid immunohistochemical markers more frequently.