Immunoprofiles in Malignant Peripheral Nerve Sheath Tumor: Three Case Reports and Literature Review

因為缺乏特殊的影像學和病理診斷標準，對於病理醫師來說，要區分惡性周圍神經鞘腫瘤和其他的腫瘤，往往是一項大挑戰。早期發現良性周圍神經鞘腫瘤的惡性轉變，能有較好的預後，所以很多的免疫組識化學和分子學的研究宛如雨後春筍般的出現。然而，文獻上還是沒有統一的診斷標準。S-100一直是廣泛的用在惡性周圍神經鞘腫瘤的診斷上，而p53和Ki-67也是最有前景的輔助工具，不過，文獻上少有它們的染色類型分布和機轉的探討，於是這引發我們的興趣，我們搜尋高雄醫學大學附設醫院病理科的報告資料庫，從1988年到2005年九月間，只找到六位診斷為惡性周圍神經鞘腫瘤的病患，其中三位有病例記載。我們發現與以往文獻上些許不同的免疫組識化學染色差異，在此我們提出這罕見的腫瘤，並回顧一下文獻紀錄。

關鍵字

惡性周圍神經鞘腫瘤； s-100 ； P53 ； Ki-67

並列摘要

Because there are no standardized radiologic and histologic criteria, the differential diagnosis of malignant peripheral nerve sheath tumors (MPNSTs) from other spindle cell neoplasms poses great challenges for pathologists. Because early diagnosis of MPNSTs arising from benign peripheral nerve sheath tumors (BPNSTs) means a better prognosis, many immunohistochemical and molecular studies have recently emerged. Nevertheless, no gold standard diagnostic criterion is to be found in the literature. For example, S-100 protein is widely used in the diagnosis of MPNST. Other promising ancillary markers are p53 and Ki-67; however, the staining patterns and possible mechanisms of these markers are seldom mentioned in the literature. These evoke our interest. Only six cases diagnosed as MPNST were retrieved from the archives of the Department of Pathology, Kaohsiung Medical University Chung-Ho Memorial Hospital between 1988 and September 2005. Clinical files were available for three of them, and we found nuances in the immunohistochemistry from these previous reports. Here, we present these rare sarcomas and review the literature.

並列關鍵字

malignant peripheral nerve sheath tumor ； S-100 ； p53 ； Ki-67

國際替代計量

Immunoprofiles in Malignant Peripheral Nerve Sheath Tumor: Three Case Reports and Literature Review

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