摘要
目的探讨血管瘤样纤维组织细胞瘤(AFH)的临床病理特征。方法对1例发生于左肩的血管瘤样纤维组织细胞瘤的临床表现、组织形态、免疫组化等进行分析,并复习相关文献。结果患者男性,19岁。左肩部缓慢生长的无痛性肿块。镜检:瘤细胞为增生的组织细胞样细胞或肌样细胞,可见含铁血黄素颗粒和假血管样腔隙、较厚的纤维性假包膜和周围淋巴细胞浆细胞浸润。免疫组化:vimentin、CD57和CD99均(+),SMA、CD68和结蛋白部分(+),CD21、CD31、CD34、CD117、CKpan、S-100、calponin和synaptophysin均(-)。结论血管瘤样纤维组织细胞瘤是一种罕见的低度恶性中间型肿瘤,临床上易与血肿、血管瘤混淆。其诊断主要靠病理形态学特征,免疫组化标记有助于诊断与鉴别诊断;肿块局部扩大切除,必要时可局部放疗,术后随访尤其重要。
Objective To study the clinicopathogic features of angiomatoid fibrous histiocytoma.Methods The clinical manifestations,histiopathological and immuhistochemical results were analyzed in one case of angiomatoid fibrous histiocytoma occurring in the left shoulder with review of the related literatures.Results The patient was a 19 year-old man.The patient primarily presented with a slowly enlarging painless subcutaneous mass.Gross examination showed that the tumor was well-circumscribed and had a grey-colored cut surface with focal hemorrhagic cystic changes.Histologically,the tumor was composed of histiocytoid or myoid cells arranged in nodular pattern.Hemosiderin and pseudovascular blood spaces were found.Immunohistochemical study showed that all of them were positive for vimentin,CD57,CD99 and negative for CD21,CD31,CD34,CD117,CKpan,S-100,calponin and synaptophysin.A portion of tumor cells were positive for SMA,CD68 and desmin.Conclusions Angiomatoid fibrous histiocytoma is a rare soft tumor of intermediate malignant potential,which is difficult to be distinguished from hematoma or hemangioma.Definitive diagnosis requires histological examination and clinical correlation.Immunohistochemistry is also helpful for diagnosis and differential diagnosis.Wide local excision with post-operative follow-up,as well as local radiotherapy when required,is the main modality of treatment.
出处
《诊断病理学杂志》
CSCD
2011年第5期361-364,共4页
Chinese Journal of Diagnostic Pathology
