软组织肿瘤及肿瘤样病变的病例及相关问题 下课件.ppt

Case 2 Presented by Hiroshi Hashimoto, MD. University of Occupational and Environmental Health Kitakyushu, Japan Immunohistochemical Results a-SMA HHF35 desmin h-caldesmon calponin HMB45 MyopericytomaThe term was adopted by Granter et al. in 1998. Definition: a benign tumors histologically characterized by a striking concentric perivascular proliferation of spindle cells and showing apparent differentiation toward perivascular myoid cells or myopericytes. Generally presents as a painless, slow-growing subcutaneous nodule. Some lesions are painful. The lower extremities are most commonly affected, followed by the upper extremities. Multiple lesions are not infrequent. Immunohistochemically, all cases stain positively for SMA, and most are positive for h-caldesmon, while desmin is only focally positive in occasional cases. Most do not recur. Very rare malignant myopericytomas exist. * ?　54-year-old man. ?　Subcutaneous nodule and pain in the left forearm for 5 years. ?　The tumor is well-circumscribed and measures 1.5 cm in the greatest diameter. ?　He was well with no evidence of recurrence 7 mos. after the marginal local excision. a-smooth muscle actin h-caldesmon desmin + + - + + - Diagnosis Myopericytoma with angioleiomyoma-like areas PERICYTIC (PERIVASCULAR) TUMOURS In WHO Classification of Soft Tissue Tumours in 2002 Glomus tumour (and variants) malignant glomus tumour Myopericytoma FIBROBLASTIC/MYOFIBROBLASTIC TUMOURS In WHO Classification of Soft Tissue Tumours in 2002 　　Intermediate (rarely metastasizing) Solitary fibrous tumour and haemangiopericytoma (including lipomatous haemangioericytoma) Inflammatory myofibroblastic tumour Low grade myofibroblastic sarcoma Myxoinflammatory fibroblastic sarcoma Infantile fibrosarcoma *