胃肠道及系膜反应性结节性纤维假瘤临床病理分析  

Reactive nodular fibrous pseudotumor of gastrointestinal tract and mesentery:a clinicopathologic study of 4 cases

作　　者：宋林红[1] 张洁[2] 徐钢[1] 董丹丹[1] 

机构地区：[1]四川省人民医院病理科,成都610072 [2]彭州市人民医院病理科,四川彭州611930

出　　处：《诊断病理学杂志》2007年第1期20-23,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨胃肠道及系膜反应性结节性纤维假瘤(RNFP)的临床病理特征、免疫表型和鉴别诊断。方法回顾性分析4例RNFP的临床资料、病理学形态和免疫组化标记结果。结果本组3例为腹腔内多发性结节,累及肠壁和胃壁。肉眼观卵圆形肿块境界清楚,切面灰白色,质韧;镜检见少量梭形细胞或星形细胞杂乱稀疏地分布于玻璃样变的胶原间质中,部分胶原呈瘢痕样改变,间质内有多少不等的淋巴细胞呈斑片状分布,病灶周边可见残留和内陷的神经束和脂肪组织。免疫组化vimentin、CD117、-αSMA和MSA(+),ALK-1和CD34(-)。结论胃肠道RNFP是一种不同于炎性肌纤维母细胞肿瘤的伴有肌纤维母细胞反应性增生的炎性纤维性病变,常发生于腹部手术后。组织学上需与多种肿瘤性病变,特别是炎性肌纤维母细胞肿瘤和胃肠道(外)间质肿瘤鉴别。Objective To study the clinicopathologic and immunohistochemical features of reactive nodular fibrous pseudotumor of the gasrointestinal tract and mesentery （RNFP） and to discuss the differential diagnosis. Methods The clinical, pathologic and immunohistochemical features were reevaluated in 4 cases. Results The tumors were multiple in 3 patients and solitary in one, and some of the tumors involved the intestine or stomach. The tumors were firm, tan-white, ranged in size from 1 to 5 cm in greatest dimension, and grossly well circumscribed. All of the lesions were low cellularity and composed of spindled or steUate fibroblasts arranged haphazardly, enmeshed in a collagenous stroma, which was hyalinized or keloidal. Lymphocytes were sparse but frequently arranged in lymphoid aggregates. The borders of the lesions had entrapped nerves and adipose tissue.Immunohistochemical stains demonstrated the tumors were positive for vimentin, CD117, α-SMA, MSA. None stained for ALK-1, CD34, S-100 protein. Follow up information was available in 2 cases, both stable at 11-29 months. Conclusions RNFP of the gastrointestinal tract and mesentery is a fibroinflammatory lesion with myofibroblastic hyperplasia, which differs from inflammatory myohbroblastic tumor, and trequently associated with abdominal trauma. RNFP needs to be differentiated from a variety of fibroblastic lesions, especially inflammatory myofibroblastic tumor and GIST.

关 键 词：反应性结节性纤维假瘤 炎性肌纤维母细胞肿瘤 病理学 

分 类 号：R730.262[医药卫生—肿瘤]