本文關(guān)鍵詞： 肌纖維瘤 肌周細(xì)胞瘤 肌纖維母細(xì)胞瘤　出處：《華中科技大學(xué)學(xué)報(bào)(醫(yī)學(xué)版)》2017年05期 　論文類型：期刊論文

【摘要】：目的探討肌纖維瘤的臨床、影像學(xué)和病理學(xué)的特點(diǎn),以及診斷和鑒別診斷。方法收集23例肌纖維瘤,結(jié)合臨床特點(diǎn)及影像學(xué)表現(xiàn),應(yīng)用蘇木精-伊紅染色觀察腫瘤的病理組織學(xué)特點(diǎn)以及EnVision法免疫組化染色檢測(cè)SMA、Caldesmon、Desmin、CD34、S-100、β-catenin、Ki67等相關(guān)指標(biāo)的表達(dá)。結(jié)果 23例患者中男性18例,女性5例;年齡12d~61歲。發(fā)病部位頭頸部13例,四肢6例,軀干2例,骨內(nèi)2例;腫瘤表現(xiàn)為孤立性腫塊21例,多中心性病變2例;腫瘤大小從0.5~8.5cm不等。21例患者表現(xiàn)為境界清楚的結(jié)節(jié),2例表現(xiàn)為局部浸潤性生長;1例局部累及頜面骨表面。腫瘤組織學(xué)表現(xiàn)為雙相模式:低倍鏡呈結(jié)節(jié)狀或多結(jié)節(jié)狀構(gòu)象,高倍鏡下見結(jié)節(jié)周邊區(qū)為肥胖的肌纖維母細(xì)胞樣細(xì)胞排列呈短束狀或旋渦狀;結(jié)節(jié)中心部位細(xì)胞則為圓形、多角形,細(xì)胞呈實(shí)性片狀分布,或呈"血管外皮瘤樣"構(gòu)象。瘤細(xì)胞無明顯異型性,核分裂象罕見。免疫組化結(jié)果顯示腫瘤細(xì)胞強(qiáng)表達(dá)SMA,部分表達(dá)Caldesmon;但Desmin、S-100、β-catenin及CD34陰性,Ki67增殖指數(shù)低。結(jié)論肌纖維瘤是一種較為罕見的軟組織腫瘤,臨床生物學(xué)行為呈良性表現(xiàn),可有局部浸潤;病理組織學(xué)具有特征性的雙相性構(gòu)象;免疫組化SMA陽性,而Desmin等陰性。臨床上要與其他組織學(xué)形態(tài)類似良性和惡性腫瘤相鑒別。
[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.
【作者單位】： 湖北省第三人民醫(yī)院腫瘤內(nèi)科;華中科技大學(xué)同濟(jì)醫(yī)學(xué)院附屬同濟(jì)醫(yī)院病理研究所;
【分類號(hào)】：R738.7

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