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目的探讨老年人头面部脉管肉瘤的临床病理学特征。方法 1996年2008年对5例老年人头面部脉管肉瘤的临床资料、病理形态学、免疫组织化学染色进行观察,并对其中4例进行了随访。结果临床表现主要是头面部发生的瘀斑、溃疡或结节状病变。肿瘤细胞围绕皮肤附件周围排列成交通状吻合的血窦网,衬覆有异型性的内皮细胞,有的区域内皮细胞形成乳头状突起。肿瘤组织内有不同程度的弥漫性出血。肿瘤细胞表达CD34、CD31、Fli-1和FⅧ,部分表达CD117和CK8/18。经随访3例3年内死亡,1例带瘤存活1年余,1例失访。结论老年人头面部脉管肉瘤组织形态多样,预后较差,及时诊治十分重要。需要与其他皮肤良性血管病变和低分化癌、恶性黑色素瘤、恶性梭形细胞肿瘤、Kaposi肉瘤等鉴别。
Objective To investigate the clinicopathological features of head and facial vascular sarcoma in the elderly. Methods The clinical data, pathomorphology and immunohistochemical staining of head and facial vascular sarcoma in 5 elderly patients were observed in 1996, 2008 and 4 of them were followed up. Results The main clinical manifestations of ecchymosis, ulcers or nodular lesions occurred in the head and face. Tumor cells around the skin appendages arranged around the traffic-like anastomosis of the sinusoid, lined with atypical endothelial cells, and some regional endothelial cells to form papillary processes. There are varying degrees of diffuse hemorrhage in the tumor tissue. Tumor cells expressed CD34, CD31, Fli-1 and FⅧ, partially expressing CD117 and CK8 / 18. Three patients were followed up within 3 years of death, 1 patient survived more than 1 year, 1 patient lost. Conclusion The morphology of head and facial vascular sarcoma in the elderly is diverse and the prognosis is poor. It is very important to diagnose and treat the disease in time. Need and other skin benign vascular lesions and poorly differentiated cancer, malignant melanoma, malignant spindle cell tumor, Kaposi sarcoma and other identification.