摘要
目的 探讨树突状纤维黏液脂肪瘤的临床病理特征 ,并讨论与其他易于混淆的软组织肿瘤的鉴别诊断。方法 收集 8例树突状纤维黏液脂肪瘤 ,观察和分析其临床和病理组织学特征 ,并通过免疫组织化学标记链霉素卵白素生物素 (LSAB)法 ,分析其CD34、bcl 2、波形蛋白、细胞角蛋白(CK)、上皮膜抗原 (EMA)、S 10 0、HHF35和平滑肌肌动蛋白 (SMA)等的表达。结果 该肿瘤主要见于中老年男性皮下软组织或肌筋膜 ;主要分布在颈、背、肩及小腿 ,也可见于面部和足部。大体上边界清楚或有薄包膜 ,切面部分呈黏液样或胶冻状。该肿瘤在组织形态学上以成熟脂肪组织、增生的梭形细胞或星状细胞、黏液样及纤维化间质等为主要成分 ,在不同区域以不同的比例混杂构成。梭形细胞或星状细胞伸出细长分枝状胞质突起是其形态特征之一。无细胞异型性和核分裂象。此外 ,该肿瘤常有较丰富的丛状小血管和毛细血管 ,间质有肥大细胞、小淋巴细胞及浆细胞浸润。免疫组织化学染色梭形细胞显示CD34、bcl 2和波形蛋白强阳性 ,而HHF35、SMA和S 10 0阴性 ,肿瘤中所有成分对CK和EMA呈阴性反应。结论 树突状纤维黏液脂肪瘤在临床表现、病理组织学改变以及免疫组织化学反应等方面有其独自的特点。
Objective To study the clinicopathologic features of dendritic fibromyxolipoma for the purpose of differentiating it from other confusable soft tissue neoplasms. Methods Eight cases of dendritic fibromyxolipoma were obtained and their clinicopathologic features were studied. Immunohistochemistry stains for CD34, bcl-2, vimentin, cytokeratin, EMA, S-100, HHF35 and smooth muscle actin were performed with labeled streptavidin-biotin (SLAB) system on DAKO auto-immunohistochemical stainer. Results Dendritic fibromyxolipoma usually occurrs in middle-aged to elderly men, developing primarily in the subcutis or muscular fascia of the head and neck region, shoulder, back, calf and foot. Grossly, it is well-circumscribed, partly thinly encapsulated lesion with focal mucinous or gelatinous cutting surface. Histologically, all these tumors showed similar histological features. , and were characterized by an admixture of mature adipose tissue, spindle and stellate cells, and abundant myxoid stroma with prominent collagenization. The proportion of above elements varied in different tumors or in different areas within the same tumor. One of the pathologic characteristics was the proliferation of spindle cells and stellate cells showing thin cytoplasmic dendritic prolongations. No cytological atypia or mitotic activity could be identified. Furthermore, the lesions were well-vascularized and the vascular elements consisted of small to median-sized and capillary-sized plexiform vessels. Spindle cells were strongly positive for CD34, bcl-2 and vimentin but negative for S-100 protein and epithelial and muscle markers. Conclusions Dendritic fibromyxolipoma is characterized by clinicopathologic and immunohistochemical features. Based on those features of this tumor, this entity appears to represent a transitional form between spindle cell lipoma and solitary fibrous tumor, and should be distinguished from myxiod liposarcoma and myxoid malignant fibrous histiocytoma. Due to the benign nature of this lesion, simple local excision is curative.
出处
《中华病理学杂志》
CAS
CSCD
北大核心
2003年第5期404-408,共5页
Chinese Journal of Pathology
