Myopericytoma
夏成青 赵明 刘正智
更新时间:2020-04-07 10:34:00
概述:
发病部位:四肢、颈部和胸椎
诊断要点:
2. 镜下可见形态相对一致的卵圆形至梭形肌样细胞组成围绕小至中等大血管周围呈同心圆状或漩涡状生长;
3. 肌样细胞胞质嗜酸性,核染色质均匀,核异型性不明显,核分裂像一般少于1/10HPF;
4. 同心圆或漩涡状结构之间基质可伴有黏液样变性;
5. 部分病例瘤细胞偏丰富,呈片状分布;局部区域血管也可呈分支状,类似血管外皮瘤;
6. 部分病例内尚可见嗜伊红色、漩涡状的肌样结节,可突向血管腔,类似肌纤维瘤/肌纤维瘤病;
7. 部分病例瘤细胞相对稀疏,间质常伴有玻璃样变性;
8. 少数病例肿瘤完全位于静脉性血管腔内;
9. 少数病例可发生于AIDS患者并伴有EBV感染, 常表现为多发,多见于较为特殊的部位如颅内,椎管内,支气管等部位,组织学上瘤细胞较丰富,可呈上皮样特征,可见核分裂象,背景中可见较多的淋巴细胞浸润;
免疫组织化学染色:
分子标记:
鉴别诊断:
1、肌纤维瘤:好发于2岁以内的婴幼儿,常多结节生长,有独特的双相表现,常伴黏液变性的间质。
2、血管平滑肌瘤:皮下深层的痛性小结节,束状增生的梭形瘤细胞围绕血管生长,瘤细胞胞浆较肌周细胞瘤嗜酸,血管壁也较厚,DES,SMA阳性。
预后:
治疗:
参考文献:
1.Zhao M et al: Benign perivascular myoid cell tumor (myopericytoma) of the urinary tract: a report of 2 cases with an emphasis on differential diagnosis. Hum Pathol. 45(5):1115-21, 2014
2.Fisher C: Unusual myoid, perivascular, and postradiation lesions, with emphasis on atypical vascular lesion, postradiation cutaneous angiosarcoma, myoepithelial tumors, myopericytoma, and perivascular epithelioid cell tumor. Semin Diagn Pathol. 30(1):73-84, 2013
3.Dhingra S et al: Renal myopericytoma: case report and review of literature. Arch Pathol Lab Med. 136(5):563-6, 2012
4.Mainville GN et al: Primary Malignant Myopericytoma of the Left Atrium-A Tumor of Aggressive Biological Behavior: Report of the First Case and Review of Literature. Appl Immunohistochem Mol Morphol. Epub ahead of print, 2012
5.Díaz-Flores L et al: Myopericytoma and arterial intimal thickening: the relationship between myopericytes and myointimal cells. J Cutan Pathol. 38(11):857-64, 2011
6.Lau PP et al: Myopericytoma in patients with AIDS: a new class of Epstein-Barr virus-associated tumor. Am J Surg Pathol. 33(11):1666-72, 2009
7.Ide F et al: Perivascular myoid tumors of the oral region: a clinicopathologic re-evaluation of 35 cases. J Oral Pathol Med. 37(1):43-9, 2008
8.Matsuyama A et al: Angioleiomyoma: a clinicopathologic and immunohistochemical reappraisal with special reference to the correlation with myopericytoma. Hum Pathol. 38(4):645-51, 2007
9.Wilson T et al: Intranasal myopericytoma. A tumour with perivascular myoid differentiation: the changing nomenclature for haemangiopericytoma. J Laryngol Otol. 121(8):786-9, 2007