- 期刊
Retroperitoneal Undifferentiated Sarcoma in a Hemodialysis Patient
一位血液透析病患的後腹腔未分化肉瘤
摘要
後腹腔未分化肉瘤，其特性為在免疫組織化學染色下，無法染出特異之細胞分化指標，只能染出高強度之肉瘤指標”Vimentin”。文獻上這類腫瘤從未發表發生在具有慢性免疫力低下的血液透析病人身上。我們報告一位50歲的尿毒症病患，患有後腹腔未分化肉瘤。其細胞病理特性為未分化的紡錘狀或卵圓形的肉瘤細胞，而其免疫組織化學反應排除橫紋肌肉瘤、平滑肌肉瘤、脂肪肉瘤、過誤瘤、類肉瘤性的腎細胞癌及類肉瘤性的移行性上皮細胞瘤。手術後經過3年，病人之預後良好，且無腫瘤再發之跡象。我們闡述未分化肉瘤之病理及影像特徵，並點出肉瘤形成與尿毒症之間的可能關連性。
關鍵字
無資料並列摘要
Retroperitoneal undifferentiated sarcoma is a soft tissue sarcoma that is highly positive for vimentin but has no reactions to various cell-specific markers in immunohistochemical study. This tumor has never been reported in a hemodialysis patient with chronically immunosuppressed uremic state. We report a case of retroperitoneal undifferentiated sarcoma in a 50-year-old uremic man who presented with intermittent left flank dull pain and painless hematuria. MRI revealed a huge left perirenal mass, and complete resection was achieved. The pathological examination of the tumor cells revealed poorly-differentiated spindle or oval-shaped sarcoma cells, and the immunohistochemical study excluded the diagnosis of rhabdomyosarcoma, leimyosarcoma, liposarcoma, angiomyolipoma, sarcomatoid renal cell carcinoma, and sarcomatoid transitional cell carcinoma. This indicated that the sarcoma did not show any differentiation. The patient had an uneventful postoperative course and is currently well 3 years after operation. We review the clinical picture of this tumor in a hemodialysis patient, elucidate the ”undifferentiated” histopathological characteristics by immunohistochemical study and point out the possible connection between sarcoma formation and immunosuppressive status from uremia.
延伸閱讀
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