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患者男,53岁。头部丘疹1年,肿块5个月。组织病理:真皮内可见内含红细胞的不规则管腔相互融合,浸润生长,管腔衬附细胞大小不一,核大深染,胞浆丰富,核分裂易见,异型性明显。免疫组化:CD31,CD34阳性;S-100,SMA,Des阴性。诊断:血管肉瘤。经重组人血管内皮抑制素注射液及紫杉醇方案化疗10周期后皮损缩小,因无手术切除指征,遂予局部放疗。4个月前患者右小腿出现一包块,术后病理证实为血管肉瘤。1个月前PET/CT示右小腿肌组织、左侧腮腺、盆腔、右侧腹股沟至腘窝淋巴结、右侧肱骨头均考虑恶性病变。行长春瑞滨、顺铂及重组人血管内皮抑制素注射液化疗。
Male patient, 53 years old. 1 year head papules, lumps for 5 months. Histopathology: The irregular luminal cells containing erythrocytes were fused with each other in the dermis, infiltrating and growing. The size of the luminal lining cells was different. The nucleus was deeply stained, the cytoplasm was rich, and mitosis was obvious. Immunohistochemistry: CD31, CD34 positive; S-100, SMA, Des negative. Diagnosis: Angiosarcoma. The recombinant human endostatin injection and paclitaxel chemotherapy 10 weeks after the lesion shrinks, because no indications for surgical resection, was given to local radiotherapy. 4 months before the patient appeared a mass of the right leg, postoperative pathology confirmed as angiosarcoma. 1 month ago PET / CT showed right calf muscle, left parotid, pelvic, right groin to popliteal lymph nodes, the right humeral head were considered malignant lesions. Vinorelbine, cisplatin and recombinant human endostatin injection chemotherapy.