摘要
目的探讨血管瘤样纤维组织细胞瘤(AFH)的临床特征、病理特点、免疫组化表达以及鉴别诊断。方法收集血管瘤样纤维组织细胞瘤2例,分析其临床症状,显微镜下观察其组织学形态及免疫组化特点,并复习文献进行鉴别诊断。结果临床特点:2例均为男性患者,年龄分别为14岁、7岁,表现为真皮深层或皮下缓慢生长的无痛性肿块,两者均行麻醉下单纯切除肿物,术后未行其它方式辅助治疗,分别随访37个月和33个月,无复发、转移。病理检查:2例均为单发肿瘤,切面灰白、灰红,囊实性,质硬,与周围组织界尚清;其中1例左侧腹股沟淋巴结肿大,大小约2.8 cm×2.2 cm×1cm,切面灰红,质细腻。镜下特点:肿瘤瘤细胞呈组织细胞样特点,由较厚的假包膜,周围见大量的淋巴细胞,浆细胞浸润。免疫组化:肿瘤细胞Vimentin(+)、Desmin部分(+)、CD68部分(+)、EMA(+)、CD99(+)、SMA部分(+)、MyoD1(-)、CD34(-)、CD31(-)、S⁃100(-)、CyclinD1(+),Ki⁃67阳性率5%~8%。结论血管瘤样纤维组织细胞瘤属于罕见的交界性病变,其病理诊断主要依靠组织形态及免疫组织化学标记明确诊断。表现为真皮深层或皮下缓慢生长的无痛性肿块,局部适当进行扩大切除;术后随访是主要处理原则。
Objective To study the clinical feature,pathological characteristics,immunopheno⁃type and the differential diagnosis of angiomatoid fibrous histiocytoma(AFH).Methods The clinical feature of two cases of angiomatoid fibrous histiocytoma were analyzed.The pathological characteristics,immunohis⁃tochemical study was carried out and the literatures were reviewed.Results Both of the two cases were male,age of 14 years old and 7 years old,respectively.Both of the painless solitary masses and left inguinal lymph nodes were resected completely under anesthesia with no other adjuvant treatment after operation.Dur⁃ing a period of follow 37 months and 33 month the patients had no recurrence or distant metastasis.Gross ex⁃amination showed that they were well circumscribed and had a grey cut surface,with focal cystic and solid change.The size of left inguinal lymph nodes were 2.8×2.2×1 cm,with grayish red colour and exquisite cut surface.Histologically,the tumor was composed of histiocytoid cells which was with a fibrous pseudocapsule surrounded by lymphncytes and plasma cells.Immunohistochemical study showed that Vimentin(+),EMA(+),CD99(+),CyclinD1(+);part of Desmin,CD68,SMA were positive.MyoD1,CD34,CD31,S⁃100 were negative,the positive of Ki⁃67 was 5%-8%.Conclusions AFH is a rare borderline tumor,and the de⁃finitive diagnosis requires thorough histomorphology and immunohistochemical study.The patients primarily presented with a painless mass that grows deep in the dermis or subcutaneously;and the principle of treatment is enlarged surgical resection of local lesions and postoperative follow⁃up.
作者
王芳
相龙全
王海庆
程军
周凤娟
WANG Fang;XIANG Longquan;WANG Haiqing;CHENG Jun;ZHOU Fengjuan(Department of Pathology,Jining NO.1 People's Hospital,Jining,Shandong,China,272111;Department of Vascular Surgery,Jining NO.1 People's Hospital,Jining,Shandong,China,272111;Department of ra⁃diology,Binzhou People's Hospital,Binzhou,Shandong,China,256610)
出处
《分子诊断与治疗杂志》
2020年第2期166-169,189,共5页
Journal of Molecular Diagnostics and Therapy
