摘要
背景与目的 炎性肌纤维母细胞肿瘤（inflammatory myof-broblastic tumors，IMTs）是近年认识到的一种较少见的软组织肿瘤，肺是其好发部位之一。本观察旨在研究肺IMTs有诊断价值的临床病理学特点。方法 收集9例肺IMTs的临床病理资料并随访，对切除标本进行HE染色和免疫表型检测。结果 9例患者以咳嗽、咳痰、呼吸困难为主要临床表现。其中7例为良性，2例为恶性。良性IMTs的瘤细胞呈梭形，体积较大，胞质弱嗜酸性，核圆形或椭圆形，核分裂0～2个／50HPF，恶性IMTs在良性IMTs的基础之上表现为瘤细胞排列较紊乱，细胞异型性大，核仁明显，核分裂〉25个／50HPF，IMTs组织内均可见神经节样肌纤维母细胞和浆细胞、淋巴细胞浸润；免疫表型检测显示全部病例瘤细胞呈波形蛋白、肌特异性肌动蛋白和α-平滑肌肌动蛋白（4-），部分病例的部分瘤细胞呈结蛋白、间变性淋巴瘤激酶1（4-），p53均呈（-）。结论 肺IMTs临床表现无典型性，肿瘤由大量具有肌纤维母细胞特征的瘤细胞构成，伴有较多炎细胞浸润，手术切除肿瘤是治疗的首选方法，良性者预后好，恶性者预后较差。
Background and objective Inflammatory myofibroblastic tumors （IMTs） are rare tumors of soft tissue recognized recently and the lung is one of common organs involved, The aim of this study is to investigate the valuable clinicopathological features for diagnosis of IMTs of the lung. Methods The clinicopathology data of 9 patients with IMTs were collected. The resected lesions of the patients were studied by histological and immunohistochemical methods. Results The 9 patients＇ symptoms mainly included cough, expectoration and dyspnea. Seven patients displayed as benign IMTs and 2 malignant IMTs. The big spindle neoplastic myofibroblastic cells of the benign IMTs had eosinophilic cytoplasm and round or oval nuclei. Mitoses were generally scanty （0-2/50HPF）. Compared with the benign IMTs, the malignant IMTs displayed highly atypical polygonal cells with oval vesicular nuclei, prominent nucleoli and variable mitoses （〉25/50HPF）. Ganglion-like myofibroblastic cells with plasma cells, and lymphocytes invasion could be seen in all IMTs. The immunohistochemical results were： in all patients vimentin, muscle-specific actin and α-smooth muscle actin （＋）, p53 （-）, while some patients desmin and anaplastic lymphoma kinase-1 （＋）. Conclusion IMTs patients＇ symptoms are atypical. IMTs are composed with abundant myofibroblasts accompanied with many inflammatory cells. Surgical resection is the first choice for IMTs, complete resection leads to excellent survival for benign IMTs but not very well for malignancy.
出处
《中国肺癌杂志》
CAS
2007年第2期116-119,共4页
Chinese Journal of Lung Cancer
关键词
炎性肌纤维母细胞肿瘤
临床病理
免疫组化
Inflammatory myofibroblastic tumors
Clinicopathological
Immunohistochemical
