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目的:探讨软组织软骨瘤(STC)临床病理学特征及其组织学发生机制。方法:对11例STC的临床表现、组织学形态及免疫组化表型进行分析。结果:临床上主要表现为局部缓慢性生长的无痛性肿块,少数伴有局部压痛,术后罕见复发。影像学显示,与骨无关联的软组织内肿块伴有程度不等的钙化。镜下肿瘤组织境界清楚,分叶状,由成熟透明软骨或纤维软骨构成,可伴有程度不等的钙化、黏液变及囊性变;软骨瘤细胞形态不一,多无异形性,核分裂像罕见;少数软骨小叶周边梭形间质细胞密集,无胞周空晕或陷窝状结构。免疫组化显示,所有成分均表达vimentin,成熟软骨细胞及梭形软骨细胞还部分表达S-100及CD34;软骨结节周边梭形间质细胞部分表达a-SMA、MSA及CD34,散在表达CD163;透明软骨基质CollagenⅡ表达程度不等,CollagenⅠ及CollagenⅢ呈阴性表达或局灶弱阳性表达;纤维软骨基质及钙化区表达CollagenⅠ及CollagenⅢ,CollagenⅡ表达阴性或局灶弱阳性表达。结论:STC是一种较为少见的软组织良性软骨性肿瘤,STC的形成可能最初由间充质细胞演化为具有CD34阳性表达的梭形间质细胞,继而向软骨方向分化形成STC,但这一演化机制有待深入研究。
Objective: To investigate the clinicopathological features and histopathological features of soft tissue chondroma (STC). Methods: The clinical manifestations, histological features and immunohistochemical phenotypes of 11 cases of STC were analyzed. Results: The main clinical manifestations of locally slow growth of painless mass, a few with local tenderness, rare recurrence after surgery. Radiographically, soft tissue masses unrelated to bone were associated with varying degrees of calcification. Microscopically clear state tumor tissue, lobulated, by the mature hyaline cartilage or cartilage, may be associated with varying degrees of calcification, mucus change and cystic degeneration; chondroma cell morphology, and more non-atypia, mitotic Rare; spindle-shaped mesenchymal cells around a small number of cartilage lobules dense, no periventricular halo or dimple-like structure. Immunohistochemistry showed that vimentin was expressed in all the components, and S-100 and CD34 were partially expressed in mature chondrocytes and spindle cartilage cells; a-SMA, MSA and CD34 were partially expressed in the spindle-shaped stromal cells in the periphery of cartilage nodules, scattered CD163 ; The expression of CollagenⅡ in hyaline cartilage matrix was not equal, Collagen Ⅰ and Collagen Ⅲ were negative or focal weakly positive expression; Collagen Ⅰ and Collagen Ⅲ were expressed in matrix and calcification area of fibrocartilage; CollagenⅡ expression was negative or focal weak positive expression. CONCLUSIONS: STC is a rare soft tissue benign cartilaginous tumor. The formation of STC may initially evolve from mesenchymal cells to spindle-shaped stromal cells with CD34 expression, which then differentiate into cartilage to form STC. However, this evolution Mechanism needs further study.