摘要
目的探讨瘢痕疙瘩样皮肤纤维组织细胞瘤(FH)和隆突性皮肤纤维肉瘤(DFSP)的临床和病理学特征及免疫表型,为临床诊治提供依据。方法2015年3月至2019年3月,郑州大学第一附属医院整形外科收集FH 12例[男5例,女7例,年龄14~76(37.67±17.71)岁],DFSP 9例[男5例,女4例,年龄19~64(42.56±13.82)岁]临床资料进行分析,并对FH和DFSP的临床表现、组织病理学特点和免疫表型进行比较。结果21例患者临床表现均为体表肿物,外观呈瘢痕疙瘩样改变,全部行手术治疗,术后行常规病理检查和免疫组织化学染色确诊为FH 12例,其中CD6810例阳性,SMA 9例阳性,S-100均为阴性。确诊为DFSP 9例,其中2例为纤维肉瘤样DFSP,7例DFSP中CD34全部阳性,CD685例阴性,SMA 6例阴性。2例纤维肉瘤样DFSP中CD34,CD68,SMA均为阴性。随访6个月至4年,FH病例无复发,DFSP 3例复发,其中2例为纤维肉瘤样DFSP,1例纤维肉瘤样DFSP出现远处转移。结论部分FH和DFSP的临床表现和病理学特征与瘢痕疙瘩有一定相似度,鉴别诊断困难,早期确诊和规范化治疗对预后至关重要。
Objective To investigate the clinical and pathological features and immunophenotyping of keloidal cutaneous fibrous histiocytoma(FH)and dermatofibrosarcoma protuberans(DFSP)to provide evidence for clinical diagnosis and treatment.Methods The clinical data were colleceted from March 2015 to March 2019 and retrospectively analyzed,including 12 cases of FH,5 males and 7 females,aged 14-76 years,with average age(37.67±17.71)years and 9 cases of DFSP,5 males and 4 females,aged 19-64 years,with average age(42.56±13.82)years.The clinical manifestations,histopathological features and immunophenotyping of FH and DFSP were compared.Results The clinical manifestations of all cases were keloid-like lesions.All patients underwent surgical treatment.12 cases of FH were diagnosed in the postoperation routine pathological examination and immunohistochemical staining,CD68 was positive in 10 cases,9 cases of SMA were positive and all of S-100 were negative.9 cases of DFSP were diagnosed and 2 cases were fibrosarcomatous DFSP among them.For the 7 cases of DFSP,CD34 were all positive,5 cases of CD68 were negative,6 cases of SMA were negative.For 2 cases of fibrosarcomatous DFSP,CD34,CD68 and SMA were all negative.During the follow-up period from 6 months to 4 years,there was no recurrence of FH cases,and 3 cases of DFSP recurred,2 cases were fibrosarcomatous DFSP among them,and 1 case of fibrosarcomatous DFSP presented distant metastasis.Conclusions The clinical manifestations and pathological features of some FH and DFSP are similar to keloids in a certain extent,and there is a little difficulty for clinical differential diagnosis.Early diagnosis and standardized treatment are crucial for prognosis.
作者
王琪影
苑田田
张俊辉
彭倩
翟晓梅
Wang Qiying;Yuan Tiantian;Zhang Junhui;Peng Qian;Zhai Xiaomei(Department of Plastic Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Scar Research Center of Zhengzhou University,Zhengzhou 450052,China)
出处
《中华医学美学美容杂志》
2020年第4期290-293,共4页
Chinese Journal of Medical Aesthetics and Cosmetology
