11例炎性肌纤维母细胞瘤的临床病理分析

发布时间：2018-11-06 08:55

【摘要】：目的:研究炎性肌纤维母细胞瘤(inflammatory myofibroblastic tumor,IMT)的临床病理特点、免疫表型与诊断和预后的关系。方法:收集2013年9月至2016年6月就诊于广西医科大学附属肿瘤医院11例IMT患者的临床病理资料,其中男性6例、女性5例,年龄13~66岁。采用免疫组织化学En Vision法等检测相关免疫标记物,分析和总结其主要的临床病理特点。结果:11例IMT患者肿瘤发生于肺脏、纵隔、肝脏、腹腔、膀胱等部位。镜下见肿瘤由梭形纤维母细胞和肌纤维母肿瘤细胞增生构成,伴有数量不等的慢性炎细胞,个别病例见脓肿形成。间质有不同程度的黏液背景或胶原化。预后不良病例肿瘤细胞有异型性,见圆形或上皮样细胞形态及核仁。免疫组织化学染色结果显示,肿瘤细胞vimentin、ALK、SMA、S-100、CD117、CD34的阳性率依次为:91%(10/11)、55%(6/11)、100%(11/11)、27%(3/11)、18%(2/11)、9%(1/11),Ki-67阳性率为3%~40%,CK、H-caldesmon、DOG1均为阴性。随访11例患者4~22个月,7例无瘤生存,4例带瘤生存,其中3例表现出侵袭性生物学行为。结论:IMT是一种少见的具有独特病理特征的潜在或低度恶性肿瘤,预后不良患者肿瘤细胞有异形性,可见圆形或上皮样细胞及核仁,增殖指数增高,免疫组织化学ALK,SMA,H-caldesmon可以帮助诊断。
[Abstract]:Objective: to study the clinicopathological features, immunophenotype, diagnosis and prognosis of inflammatory myofibroblastoma (inflammatory myofibroblastic tumor,IMT). Methods: the clinicopathological data of 11 patients with IMT were collected from September 2013 to June 2016 in the affiliated Cancer Hospital of Guangxi Medical University, including 6 males and 5 females aged 1366 years. Immunohistochemical En Vision method was used to detect the related immunomarkers and its main clinicopathological features were analyzed and summarized. Results: 11 cases of IMT tumors occurred in lung, mediastinum, liver, abdominal cavity, bladder and so on. Microscopically the tumor was composed of fusiform fibroblasts and myofibroblastoma cells with varying number of chronic inflammatory cells. Abscess was seen in some cases. The stroma has varying degrees of mucus background or collagenization. In poor prognosis cases, tumor cells were abnormal, round or epithelioid cell morphology and nucleoli. Immunohistochemical staining showed that the positive rate of vimentin,ALK,SMA,S-100,CD117,CD34 was 91% (10 / 11), 55% (6 / 11), 100% (11 / 11), 27% (3 / 11), respectively. 18% (2 / 11), 9% (1 / 11), the positive rate of Ki-67 was 34% and 40%. 11 cases were followed up for 4 ~ 22 months, 7 cases survived without tumor and 4 cases survived with tumor, 3 of them showed aggressive biological behavior. Conclusion: IMT is a rare latent or low-grade malignant tumor with unique pathological characteristics. The tumor cells with poor prognosis have abnormal shape, round or epithelioid cells and nucleoli, increased proliferative index, and immunohistochemical ALK,SMA,. H-caldesmon can help in diagnosis.
【作者单位】：广西医科大学附属肿瘤医院病理科;
【分类号】：R730.2

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