左大腿去分化脂肪肉瘤1例

D. Sengul, I. Sengul, H. Ustun
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引用次数: 3

摘要

简介:脂肪肉瘤一般分为四种亚型:a)高分化脂肪肉瘤/非典型脂肪瘤,b)去分化脂肪肉瘤,c)粘液样/圆细胞脂肪肉瘤,d)多形性脂肪肉瘤。去分化脂肪肉瘤多见于腹膜后区域。目的:报告一例发生在下肢的去分化脂肪肉瘤。病例报告:一名24岁女性,左侧大腿内侧有一硬而痛的肿块,直径3x2 cm。MRI显示该部位病变在t1加权序列上显示低信号强度,在t2a加权序列上显示高信号强度。经切除活检后,组织病理检查通过血红素和伊红首次显示诊断为恶性未分化肿瘤。免疫组化评价结果如下:SMA(-)、HMB45(-)、S100(+,局灶)、Desmin(-)、Vimentin(+,局灶)、CD68(+,局灶)、CD34(-)、LCA(-)、Inhibin(-)。最终组织病理学诊断为去分化脂肪肉瘤。结论:英语文献中关于下肢去分化脂肪肉瘤的资料非常有限。虽然有CT和MRI成像,但最终的明确诊断是免疫组织化学做出的。临床医生应注意在下肢肿块内是否存在去分化脂肪肉瘤。
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Dedifferentiated Liposarcoma of the Left Thigh: a Rare Case
Introduction: Liposarcoma is generally classified into four subtypes: a) well-differentiated liposarcoma/atypical lipomatous tumor, b) dedifferentiated liposarcoma, c) myxoid/round cell liposarcoma, and d) pleomorphic liposarcoma. Dedifferentiated liposarcoma is mostly seen in the region of retroperitoneum. Aim: To present a case of dedifferentiated liposarcoma in a rare site of location: the lower extremity. Case Report: A 24-year-old woman presented with a firm painful mass, 3x2 cm in diameter on the medial side of left thigh. MRI demonstrated a lesion on that location showing low signal intensity on T1-wieghted and high signal intensity on T2A-wieghted sequences. After an excisional biopsy the histopathological examination via Haematoxylin and Eosin firstly revealed the diagnosis of malign undifferentiated tumor. The results of immunohistochemical evaluations were as follows: SMA (-), HMB45 (-), S100 (+, focally), Desmin (-), Vimentin (+, focally), CD68 (+, focally), CD34 (-), LCA (-), and Inhibin (-). The final histopathological diagnosis was dedifferentiated liposarcoma. Conclusions: In English-language literature data for dedifferentiated liposarcoma of the lower extremities are very restricted. Although imaging with CT and MRI, the final and distinct diagnosis is made immunohistochemically. A clinician should be aware of the presence of a dedifferentiated liposarcoma within a mass on the lower extremities.
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