비장에 발생한 원발성 악성 섬유성조직구종 -1예 보고-

초록

We report a case of primary splenic malignant fibrous histiocytoma(MFH). A 72-year old man was referred to our hospital with a retroperitoneal mass which was discovered on the abdominal CT scan. He suffered from fever, weight loss, and night sweating for the last 2 months. Abdominal CT scan revealed markedly enlarged multinodular tumor in splenic area. The resected spleen measured 12.0X12.0X9.0cm and weighed 726gm. It was markedly enlarged in global shape. The splenic capsule was intact. Cut surface showed near total replacement of splenic parenchyma by a lobulated yellow white solid mass with geographic necrosis. Histology showed a tumor composed of plump pleomorphic spindle or polygonal cells with many neutrophils. There were numerous mitotic figures, including some atypical ones. The appearance were consistent with the inflammatory subtype of a MFH. These cells were strongly positive for vimentin, and showed patchy positivity for cytokeratin and EMA. Stains for S-100 protein, HMB45, LCA, CD3, 20, 30, 21, 38, and 68, CEA, B72.3, NSE, chromogranin, synaptophysin, and SMA were all negative. The patient has been surviving for 13months without any evidence of recurrence or other primary tumor.