Abstract

目的: 探讨儿童腹腔上皮样炎性肌纤维母细胞肉瘤(epithelioid inflammatory myofibroblastic sarcoma,EIMS)的临床病理特征、免疫组织化学及分子遗传学特点。 方法: 回顾性分析上海交通大学医学院附属新华医院2015年9月至2020年9月诊断的2例儿童腹腔EIMS的临床资料、病理特征并复习相关文献。 结果: 例1患儿女,10个月,例2患儿男,7个月,均因发现腹部膨隆入院。组织学形态:以淋巴细胞为主伴少量中性粒细胞和浆细胞的炎性黏液样背景,大圆形细胞呈小簇状或单个散在分布,泡状核、核仁明显、核分裂象少见。肿瘤细胞表达间变性淋巴瘤激酶(ALK)1、ALK(D5F3)、结蛋白、CD30;部分表达广谱细胞角蛋白和平滑肌肌动蛋白;不表达panTRK、TRKA、ROS1。本组2例均为婴幼儿患者,相较于成人有以下特点:(1)核分裂象少,<5个/10 HPF(P<0.05);(2)结合相关文献分析儿童(<12岁)中位生存期>36个月,预后可能较成人好。 结论: EIMS是一种高侵袭性的恶性肿瘤,发生率比较低,发生于儿童更为罕见;其具有典型的组织学形态、ALK(D5F3)的核膜特征表达,荧光原位杂交检测显示均有ALK基因重排。.

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