【摘要】：目的:研究炎性肌纖維母細(xì)胞瘤(inflammatory myofibroblastic tumor,IMT)的臨床病理特點(diǎn)、免疫表型與診斷和預(yù)后的關(guān)系。方法:收集2013年9月至2016年6月就診于廣西醫(yī)科大學(xué)附屬腫瘤醫(yī)院11例IMT患者的臨床病理資料,其中男性6例、女性5例,年齡13~66歲。采用免疫組織化學(xué)En Vision法等檢測相關(guān)免疫標(biāo)記物,分析和總結(jié)其主要的臨床病理特點(diǎn)。結(jié)果:11例IMT患者腫瘤發(fā)生于肺臟、縱隔、肝臟、腹腔、膀胱等部位。鏡下見腫瘤由梭形纖維母細(xì)胞和肌纖維母腫瘤細(xì)胞增生構(gòu)成,伴有數(shù)量不等的慢性炎細(xì)胞,個(gè)別病例見膿腫形成。間質(zhì)有不同程度的黏液背景或膠原化。預(yù)后不良病例腫瘤細(xì)胞有異型性,見圓形或上皮樣細(xì)胞形態(tài)及核仁。免疫組織化學(xué)染色結(jié)果顯示,腫瘤細(xì)胞vimentin、ALK、SMA、S-100、CD117、CD34的陽性率依次為:91%(10/11)、55%(6/11)、100%(11/11)、27%(3/11)、18%(2/11)、9%(1/11),Ki-67陽性率為3%~40%,CK、H-caldesmon、DOG1均為陰性。隨訪11例患者4~22個(gè)月,7例無瘤生存,4例帶瘤生存,其中3例表現(xiàn)出侵襲性生物學(xué)行為。結(jié)論:IMT是一種少見的具有獨(dú)特病理特征的潛在或低度惡性腫瘤,預(yù)后不良患者腫瘤細(xì)胞有異形性,可見圓形或上皮樣細(xì)胞及核仁,增殖指數(shù)增高,免疫組織化學(xué)ALK,SMA,H-caldesmon可以幫助診斷。
[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.
【作者單位】： 廣西醫(yī)科大學(xué)附屬腫瘤醫(yī)院病理科;
【分類號(hào)】：R730.2

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