侵袭性血管黏液瘤7例临床病理分析  

Clinicopathologic Analysis of 7 Cases with Aggressive Angiomyxoma

作　　者：李林[1] 何跃东[1] 喻言[1] 蒋理海[2] 

机构地区：[1]四川大学华西第二医院,四川成都610041 [2]四川大学华西医院,四川成都610041

出　　处：《实用妇产科杂志》2011年第1期57-61,共5页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:了解侵袭性血管黏液瘤的组织学来源、临床和病理特点以及治疗方法和预后。方法:回顾性分析7例侵袭性血管黏液瘤患者的临床病理资料。结果:患者年龄18～72岁,平均43.14岁,男女比1:6。5例位于外阴,1例阴道壁,1例盆底前列腺旁区。误诊率71%。除1例行外阴广泛切除+双侧腹股沟淋巴结切除+患侧盆腔腹膜后淋巴结切除,6例均行局部肿物切除。随访2+～106月,1例复发,行介入治疗后痊愈。免疫组化阳性结果:波形蛋白(vimentin)3/3,结蛋白(desmin)3/4,平滑肌肌动蛋白(SMA)3/5,人类造血干细胞抗原(CD34)2/2,增殖细胞标记物(Ki67)2/2,染糖原(PAS)1/2,S-100蛋白(S-100)1/3。结论:侵袭性血管黏液瘤是一种罕见的具有高误诊率及局部高复发率的良性间质性肿瘤,免疫组化提示肌纤维母细胞或纤维母细胞来源,治疗以手术切除为主,无需强调广泛切除,对复发且手术困难者可以考虑介入治疗。Objective：To investigate the histological origin,clinical and pathological features,as well as the treatment and prognosis of aggressive angiomyxoma. Methods：Retrospective analysis was done to explore the clinical and pathological features of 7 cases with aggressive angiomxyoma. Results： Mean age of the Patients was 43.14 （ range from 18 to 72 years） ,the ratio of male to female was 1 ： 6. The locations of the tumor were vulva（5 cases） ,vaginal wall （one case）,and pelvic floor near the prostate（one case）. The misdiagnostic rate was 71%. One patient had radical vulvectomy and inguinal lymph nodes dissection and retroperitoneal lymph nodes dissection in one side pelvis,the other six patients only had local tumor resection. Follow-up period was 2^＋ - 106 months,1 case relapsed but was cured by interventional therapy. Positive immunohistochemistry results were as follow： Vimtin （ 3/3 ）, Desmin （3/4）, SMA （ 3/5 ）, CD34 （ 2/2 ）, Ki67 （ 2/2 ）, PAS （ 1 / 2）, S-100 （1/3）. Conclusions： Aggressive angiomyxoma is a rare benign mesenchymal tumor with high misdiagnostic rate and high local recurrence rate,immunohistochemistry result suggests its origin could be myofibroblast cell or fibroblast cell. The treatment is surgical excision, radical excision is not necessary,and interventional theraDv may be considered for those relapsed and difficult disected cases.

关 键 词：侵袭性血管黏液瘤 外阴 盆底 免疫组织化学 介入治疗 

分 类 号：R737[医药卫生—肿瘤]