epithelioid sarcoma
Introduction
Epithelioid sarcoma Epithelioid sarcoma (epithelioidsarcoma) is a slowly growing intradermal or subcutaneous nodule, and the source of the tissue is unknown. Almost all of the damage occurred in the limbs, more than half of which occurred in the hands or wrists, necrosis in the center of the nodules and a grid-like arrangement around them. There are two types of tumor cells with atypical nucleus. The tumor mainly occurs in young people between the ages of 20 and 40. Two-thirds of the tumors occur in males. The extremities are more common at the end of the extremities. Half of the literature reports that they occur in the hands. The initial findings are subcutaneous 1cm. Painless nodules of left and right diameter, ulceration after 2 to 3 months, ulceration, deep infiltration, fascia, tendon, nerve infiltration. basic knowledge The proportion of illness: 0.004% Susceptible people: no special people Mode of infection: non-infectious Complications: pneumothorax
Cause
Epithelioid sarcoma etiology
The origin of epithelioid sarcoma is unclear and is still classified as a soft tissue tumor of unknown origin. However, most scholars believe that it may be derived from a primitive mesenchymal cell with multipotential differentiation potential, so that it can differentiate into epithelial cells. It is also possible to differentiate into sarcoma cells.
Prevention
Epithelioid sarcoma prevention
There is no effective preventive measure for this disease, and early diagnosis and early treatment are the key.
The tumor grew slowly, with a 10-year survival rate of 50%. There are also reports of patients who have survived lung metastasis 23 years after surgery.
Complication
Epithelioid sarcoma complications Complications
Frequent recurrence after local resection, early lymph node metastasis, often metastasized to the lungs later, and finally pneumothorax.
Symptom
Epithelioid sarcoma symptoms Common symptoms Progressive granulosus ulcer necrosis medullary carcinoma subcutaneous nodules
The three main features of the diagnosis of this disease are the epithelioid cells that produce argyrophilic fibers, the formation of many epithelioid cell nodules surrounded by collagen fibers, and the central degeneration or necrosis of the nodules.
Epithelioid sarcoma is a slowly growing intradermal or subcutaneous nodule. Almost all lesions occur in the extremities, and more than half of them occur in the hands or wrists. The initial findings are painless nodules of about 1 cm in diameter. After 2 to 3 months, ulceration, ulceration, deep infiltration, along the fascia, tendon, nerve infiltration, tumor growth in the sarcolemma and tendon, often accompanied by necrosis of the central tumor and ulceration of the skin Early in the disease can be misdiagnosed as ring granuloma, rheumatoid nodules, fibroids, dermoid cysts, etc. The tumors mainly occur in young people aged 20 to 40 years, 2/3 occur in men, and extensive local excision in the early stage. Healed.
Examine
Epithelioid sarcoma examination
1. Visual observation
Superficial tumors, ranging from 1 to several centimeters, can be attached to the fascia, sputum, etc., the face is grayish white, bleeding and necrosis.
2. Microscopic examination
The main feature is that the epithelioid tumor cells are arranged in nodular shape, the center of the nodule is degenerated and necrotic, the tumor cells are polygonal, obese fusiform or large round, the cytoplasm is deep red or lightly stained, the nucleus is round, and the staining is shallow. They can also be blister, often with mild to moderate polymorphism.
The tumor cells embedded in the fibrous tissue are irregular nodules, and the central part of the nodule is necrotic and the surrounding is arranged in a grid. There are two types of tumor cells with atypical nuclei. The first type of cells are polygonal and rich in cytoplasm. , eosinophilic, like epithelioid cells; the second type of cells are fusiform, arranged in a spiral shape in the cells with large nodules, common transitional cells between the two types of cells, binuclear cells are rare, such as cells It is neither large nor singular. Lymphocytes are often found around cell aggregates, and some parts are also found between tumor cells.
Immunohistochemical examination of tumor cell keratin, clofied fibrin vimentin and epithelial membrane antigen can be positive, about 50% of cases CD34 positive.
Diagnosis
Diagnosis and diagnosis of epithelioid sarcoma
diagnosis
According to the clinical manifestations, the characteristics of skin lesions and histopathological features can be diagnosed.
Immunohistochemical examination of tumor cell keratin, clofied fibrin vimentin and epithelial membrane antigen can be positive, about 50% of cases CD34 positive.
Differential diagnosis
Pathologically, especially under low magnification, the disease is similar to genital granulomatous diseases, such as ring granuloma, progressive lipid necrosis, etc., should be noted for identification, other diseases that should be identified pathologically with this disease Synovial sarcoma, malignant fibrous histiocytoma, fibrosarcoma and angiosarcoma.
