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좌측 총 장골동맥에 생긴 내막육종 1예 보고

A Case of Intimal Sarcoma Arising in the Left Common Iliac Artery

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초록

Primary tumors of the great vessels are rare. Most encountered cases are sarcomas which most commonly develop in the aorta, pulmonary artery, and inferior vena cava. We experienced an inti­mal sarcoma arising in the left common iliac artery in a 68-year-old male, who suffered from clau­dication in his left lower extremity for a year and was diagnosed as arteriosclerosis obliterans, clinically. Bypass surgery was performed on the obstructive lesion. Grossly, the vascular lumen was filled with dark hemorrhagic materials. Microscopically, the lesion showed proliferation of an­aplastic spindle cells with a marked nuclear atypia, arranged haphazardly. There were numerous mitotic figures. Foci of cholesterol clefts were also found in the intima. Immunohistochemically, the tumor cells were positive for vimentin, smooth muscle actin, and cytokeratin in certain areas. Stains for CD34, desmin, myosin heavy chain, caldesmon, and S-100 protein were negative. A pathologic diagnosis was made as intimal sarcoma with myofibroblastic differentiation.

Abstract

Primary tumors of the great vessels are rare. Most encountered cases are sarcomas which most commonly develop in the aorta, pulmonary artery, and inferior vena cava. We experienced an inti­mal sarcoma arising in the left common iliac artery in a 68-year-old male, who suffered from clau­dication in his left lower extremity for a year and was diagnosed as arteriosclerosis obliterans, clinically. Bypass surgery was performed on the obstructive lesion. Grossly, the vascular lumen was filled with dark hemorrhagic materials. Microscopically, the lesion showed proliferation of an­aplastic spindle cells with a marked nuclear atypia, arranged haphazardly. There were numerous mitotic figures. Foci of cholesterol clefts were also found in the intima. Immunohistochemically, the tumor cells were positive for vimentin, smooth muscle actin, and cytokeratin in certain areas. Stains for CD34, desmin, myosin heavy chain, caldesmon, and S-100 protein were negative. A pathologic diagnosis was made as intimal sarcoma with myofibroblastic differentiation.

참고문헌 (7)

  1. Sebenik M, "Undifferentiated intimal sarcoma of large systemic blood vessels: report of 14 cases with immunohistochemical profile and review of the literature", Am J Surg Pathol, 29, pp.1184~1193 (2005)
  2. Weiss S, "Soft tissue tumors. 5th ed", pp.557~559 (2008), Mosby-Elsevier
  3. Burke AP, "Sarcomas of the great vessels: a clinicopathologic study", Cancer, 71, pp.1761~1773 (1993)
  4. Nishida N, "Histopathological characterization of aortic intimal sarcoma with multiple tumor emboli", Pathol Int, 50, pp.923~927 (2000)
  5. Keohan ML, "Chemotherapy for advanced sarcoma: therapeutic decisions and modalities", Semin Oncol, 24, pp.572~579 (1997)
  6. Lee JW, "Primary intimal sarcoma originating from pulmonary valve", Korean J Thorac Cardiovasc Surg, 33, pp.823~826 (2000)
  7. Hsing JM, "Intimal pulmonary artery sarcoma presenting as dyspnea: case report", Int Semin Surg Oncol, 4, pp.14~ (2007)

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