【摘要】 目的 探討老年人頭面部脈管肉瘤的臨床病理學特征。 方法 1996年-2008年對5例老年人頭面部脈管肉瘤的臨床資料、病理形態學、免疫組織化學染色進行觀察，并對其中4例進行了隨訪。 結果 臨床表現主要是頭面部發生的瘀斑、潰瘍或結節狀病變。腫瘤細胞圍繞皮膚附件周圍排列成交通狀吻合的血竇網，襯覆有異型性的內皮細胞，有的區域內皮細胞形成乳頭狀突起。腫瘤組織內有不同程度的彌漫性出血。腫瘤細胞表達CD34、CD31、Fli-1和FⅧ，部分表達CD117和CK8/18。經隨訪3例3年內死亡，1例帶瘤存活1年余，1例失訪。 結論 老年人頭面部脈管肉瘤組織形態多樣，預后較差，及時診治十分重要。需要與其他皮膚良性血管病變和低分化癌、惡性黑色素瘤、惡性梭形細胞腫瘤、Kaposi肉瘤等鑒別。
【Abstract】 Objective To explore the clinicopathological features of cutaneous angiosarcoma on the scalp and face in elder patients. Methods The clinical data of five elder patients with cutaneous angiosarcoma on the scalp and face from 1996 to 2008 were retrospectively analyzed. The patients underwent the light microscopy, pathomorphological examination, and immunohistochemistry. Four patients were followed up. Results Most clinical manifestation was dusky irregular erythematous plaques which were often ulcerated. The tumor was composed of asymmetric collection of angulated and irregular vascular spaces infiltrating between collagen bundles. Endothelial cells attaching to the vascular spaces had hyperchromatic irregular nuclei and prominent nucleoli. Hemorrhage was another histologic feature. Positive expression of CD34,CD31,Fli-1 and FⅧ were found in tumor cells, and expression of CD117 and CK8/18 was found in some of the patients. In the follow-up duration, three patients died in three years, and one failed to be followed up. Conclusion Cutaneous angiosarcoma of the scalp and face has various histomorphology and poor prognosis, which should be diagnosed and treated in time. It should be distinguished from benign cutaneous hemangioma, poorly differentiated carcinoma, malignant melanoma and malignant spindle cell tumor.
引用本文： 陳易華,劉太華,簡燚,范嚴嚴. 老年人頭面部脈管肉瘤的臨床病理分析. 華西醫學, 2010, 25(12): 2171-2173. doi: 復制