좌측 총 장골동맥에 생긴 내막육종 1예 보고

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. Key Words: Intimal sarcoma; Common iliac artery; Arteriosclerosis obliterans

대혈관에 생기는 원발성 종양은 매우 희귀한 종양으로 이에는 주로 육종이 많다 이들은 기원하는 혈관에 따라 조직소견, 임상 양상과 예후에서 많은 차이를 보이는데, 혈관에서 발생하는 육종 의 경우는 대다수에서 대동맥, 폐동맥과 하대정맥 등의 대혈관에 서 발생한다 그러나 기타 드물게 다른 혈관에서의 발생도 보고되 고 있다

저자들은 68세 남자의 좌측 총 장골동맥에서 발생한 내막육종 1예를 경험하였기에 문헌고찰과 함께 증례를 보고하고자 한다.