摘要
目的 探讨局限型腱鞘巨细胞瘤的临床病理学特征、诊断要点及预后。方法 收集2011—2023年北京市昌平区中西医结合医院诊断为局限型腱鞘巨细胞瘤的25例患者的临床资料,并进行组织病理学观察及随访,结合相关文献讨论其临床病理特征及预后。结果 25例患者中,男性10例,女性15例。临床症状主要表现为无痛性逐渐增大的肿块,少数患者出现不同程度的压痛或疼痛麻木症状。肿物位于手部22例,足部3例,最大径0.5~4 cm,表面灰黄色或灰白色。光镜下肿瘤主要由圆形和多边形滑膜样单核细胞组成,伴有数量不等的破骨样多核巨细胞、黄色瘤细胞、慢性炎细胞及含铁血黄素;细胞周围有明显的胶原基质,胶原基质可见不同程度的玻璃样变。25例患者中,8例肿瘤细胞生长活跃,其中2例易见核分裂象(3~6个/10 HPF)。所有病例均行开放性手术完整切除肿物。术后随访,2例复发。结论 局限型腱鞘巨细胞瘤是临床少见的良性病变,易复发,手部最常见,临床一般表现为无痛缓慢生长的肿块,部分病例可发生不同程度的压痛或麻木感。女性的发病率高于男性,确诊依靠病理形态学,治疗方式为肿物完整切除,复发可能与肿瘤细胞生长活跃、核分裂像易见等有关。
Objective To explore the clinicopathological characteristics,diagnostic key points and prognosis of localized tenosynovial giant cell tumour.Methods The clinical data of 25 patients diagnosed with localized tenosynovial giant cell tumour in Changping Hospital of Integrated Chinese and Western Medicine from 2011 to 2023 were collected.Histopathological observations and follow-up were conducted.The clinicopathological characteristics and prognosis were discussed in combination with relevant literature.Results Among the 25 patients,10 were male and 15 were female.The clinical symptoms of the 25 patients were mainly manifested as painless gradually increasing masses,and a few patients presented with varying degrees of tenderness or numbness of pain.The masses were located on the hands in 22 cases and on the feet in 3 cases.The maximum diameter ranged from 0.5 to 4 cm,and the surface was grayish yellow or grayish white.Under the light microscope,the tumor is mainly composed of round and polygonal synovioid monocytes,accompanied by varying numbers of osteoclavicular multinucleated giant cells,xanthoma cells,chronic inflammatory cells and hemosiderin.There is a distinct collagen matrix around the cells,and the collagen matrix shows varying degrees of hyaline degeneration.Among the 25 patients,the tumor cells grew actively in 8 cases,and mitotic images were easily seen in 2 cases(3-6/10 HPF).All cases underwent open surgery for complete resection of the tumor.Two cases were recurred.Conclusion Localized tenosynovial giant cell tumour is a rare benign lesion in clinical practice,prone to recurrence,and is most common in the hand.Clinically,it is generally manifested as a painless and slow-growing mass,and in some cases,varying degrees of tenderness or numbness may occur.The incidence rate is higher in women than in men.Diagnosis relies on pathological morphology.The treatment method is complete resection of the tumor.Recurrence may be related to the active growth of tumor cells and the easy visibility of mitotic images,etc.
作者
朱燃
刘维维
钟定荣
ZHU Ran;LIU Weiwei;ZHONG Dingrong(Department of Pathology,Beijing Changping Hospital of Integrated Chinese and Western Medicine,Beijing 102208,China;Department of Pathology,China-Japan Friendship Hospital,Beijing 100029,China)
出处
《中国当代医药》
2025年第19期24-28,共5页
China Modern Medicine
关键词
局限型腱鞘巨细胞瘤
临床特点
病理特征
复发
Localized tenosynovial giant cell tumor
Clinical feature
Pathological feature
Recurrence
