23例肌纤维瘤临床病理观察

发布时间：2018-02-23 17:01

  本文关键词： 肌纤维瘤 肌周细胞瘤 肌纤维母细胞瘤　出处：《华中科技大学学报(医学版)》2017年05期 　论文类型：期刊论文

【摘要】：目的探讨肌纤维瘤的临床、影像学和病理学的特点,以及诊断和鉴别诊断。方法收集23例肌纤维瘤,结合临床特点及影像学表现,应用苏木精-伊红染色观察肿瘤的病理组织学特点以及EnVision法免疫组化染色检测SMA、Caldesmon、Desmin、CD34、S-100、β-catenin、Ki67等相关指标的表达。结果 23例患者中男性18例,女性5例;年龄12d~61岁。发病部位头颈部13例,四肢6例,躯干2例,骨内2例;肿瘤表现为孤立性肿块21例,多中心性病变2例;肿瘤大小从0.5~8.5cm不等。21例患者表现为境界清楚的结节,2例表现为局部浸润性生长;1例局部累及颌面骨表面。肿瘤组织学表现为双相模式:低倍镜呈结节状或多结节状构象,高倍镜下见结节周边区为肥胖的肌纤维母细胞样细胞排列呈短束状或旋涡状;结节中心部位细胞则为圆形、多角形,细胞呈实性片状分布,或呈"血管外皮瘤样"构象。瘤细胞无明显异型性,核分裂象罕见。免疫组化结果显示肿瘤细胞强表达SMA,部分表达Caldesmon;但Desmin、S-100、β-catenin及CD34阴性,Ki67增殖指数低。结论肌纤维瘤是一种较为罕见的软组织肿瘤,临床生物学行为呈良性表现,可有局部浸润;病理组织学具有特征性的双相性构象;免疫组化SMA阳性,而Desmin等阴性。临床上要与其他组织学形态类似良性和恶性肿瘤相鉴别。
[Abstract]:Objective to investigate the clinical, imaging and pathological features, diagnosis and differential diagnosis of myofibroma. The histopathological features of the tumor were observed by hematoxylin-eosin staining and the expression of SMA-Caldesmonn desminn CD34 S-100 and 尾 -catenin Ki67 were detected by EnVision immunohistochemical staining. Results among the 23 patients, 18 were male and 5 were female, and the age was 61 years old. 6 cases of extremities, 2 cases of trunk, 2 cases of bone, 21 cases of solitary mass, 2 cases of multicentric lesions. The tumor size ranged from 0.5 cm to 8.5 cm. 21 cases showed clear boundary nodules. 2 cases showed local invasive growth and 1 case had local involvement of maxillofacial bone surface. The histology of the tumor showed a biphasic pattern: low power microscope was nodular or multi-nodular. Under high power microscope, the peripheral area of the tubercle was a short bundle or swirl of fat myofibroblast-like cells, while the cells in the center of the nodule were round, polygonal, and the cells were solid and flaky. Or "hemangiopericytoma-like" conformation. The results of immunohistochemistry showed that SMA was strongly expressed in tumor cells and Caldesmonin was partially expressed, but the proliferation index of DesminS-100, 尾 -catenin and CD34 negative Ki67 was low. Conclusion Myofibroma is a rare soft tissue tumor, and its clinical biological behavior is benign. Local infiltration; histopathological features of biphasic conformation; immunohistochemical SMA positive, but negative Desmin et al. Clinically similar to other histological morphology of benign and malignant tumor differentiation.
【作者单位】： 湖北省第三人民医院肿瘤内科;华中科技大学同济医学院附属同济医院病理研究所;
【分类号】：R738.7

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