乳腺结节性筋膜炎4例临床病理观察并文献复习

发布时间：2018-07-16 19:41

【摘要】：目的探讨乳腺结节性筋膜炎的临床病理学特征、诊断及鉴别诊断。方法采用HE染色和免疫组化En Vision法检测4例乳腺结节性筋膜炎,并进行临床病理回顾性分析。结果患者均为女性,中位年龄50.5岁,病程短,无局部外伤史,肿块平均直径1.2 cm,3例位于乳腺实质,1例紧邻皮肤。4例病变均见不同程度梭形细胞增生和红细胞外渗及不等量淋巴细胞浸润,其中3例边界不清,浸润周围乳腺及脂肪组织。3例行术中冷冻,2例与常规诊断完全符合。免疫表型:梭形细胞表达vimentin、CD10和SMA,不表达CK(AE1/AE3)、CK5/6、CK14、CAM5.2、ER和PR。随访6~93个月,4例经手术局部切除后,均未复发。结论乳腺结节性筋膜炎临床较少见,术中冷冻诊断有一定的难度,易与乳腺纤维瘤病、叶状肿瘤及低级别纤维瘤病样梭形细胞癌等良、恶性肿瘤混淆,免疫组化标记vimentin和SMA对诊断及鉴别诊断乳腺结节性筋膜炎有帮助。
[Abstract]:Objective to investigate the clinicopathological features, diagnosis and differential diagnosis of nodular fasciitis of breast. Methods four cases of nodular fasciitis of mammary gland were detected by HE staining and immunohistochemical en Vision method. Results all the patients were female, the median age was 50.5 years old, the course of disease was short and there was no history of local trauma. The mean diameter of the mass was 1.2 cm in 3 cases. One case was located in the parenchyma of the mammary gland. One case was adjacent to the skin. All the lesions showed various degrees of spindle cell proliferation, exosmosis of red blood cell and infiltration of different amount of lymphocytes. The boundary of 3 cases was not clear. Intraoperative cryopreservation was performed in 2 cases of peri-invasive breast and adipose tissue, which was in good agreement with routine diagnosis. Immunophenotypes: spindle cells expressed vimentinine CD10 and SMA. they did not express CK (AE1 / AE3), CK5 / 6, CK14, CAM5.2, ER and PR. Follow-up of 6 ~ 93 months showed no recurrence in 4 cases after local resection. Conclusion Breast nodular fasciitis is rare in clinic and it is difficult to diagnose by cryopreservation during operation. It is easy to be confused with benign and malignant tumor such as breast fibromatosis, lobular tumor and low-grade fibromatous spindle cell carcinoma. Immunohistochemical staining of vimentin and SMA is helpful in the diagnosis and differential diagnosis of nodular fasciitis of breast.
【作者单位】：新疆医科大学附属肿瘤医院病理科;
【基金】：新疆维吾尔自治区自然科学基金(2014211C115)
【分类号】：R655.8

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