青春期前型外阴纤维瘤临床病理分析  

Clinicopathologic analysis of prepubertal-type vulva fibroma

作　　者：法文 王帅 杨振中 

机构地区：[1]新华医疗集团新华医院病理科,安徽淮南232052 [2]新华医疗集团新华医院妇产科,安徽淮南232052

出　　处：《蚌埠医学院学报》2012年第5期544-547,共4页Journal of Bengbu Medical College

摘　　要：目的:探讨青春期前型外阴纤维瘤(prepubertal-type vulva fibroma,PVF)的临床病理特征。方法:分析2例PVF的临床特点,光镜观察组织病理学形态及免疫组织化学特征并复习相关文献。结果:2例分别为8岁和39岁女性,均以大阴唇肿块就诊。肿块均分布在一侧,4～5 cm大。组织学观察病变位于真皮层边界不清,由稀疏的梭形纤维母细胞样的细胞和大量胶原纤维组成,病变向皮下组织延伸,在邻近的脂肪组织及血管簇、神经周围穿插性生长;梭形细胞形态温和无异型、核分裂象未查见。免疫组织化学标记显示:瘤细胞表达波形蛋白、CD34,不表达SMA、desmin、CD99、S-100蛋白、bcl-2,成人局灶表达ER和PR。结论:PVF是一种好发于青春前期幼女或女童外阴的良性间叶性病变,偶可发生于成年人。其发生可能与激素有关并起源于外阴阴道间质细胞,表现为纤维母细胞分化特征。临床有少量病例如切除不净可局部复发,并见可自发性消退病例。Objective：To explore the clinicopathological features of prepubertal-type vulva fibroma（PVF）. Methods：The clinical manifestation,immnophenotype and pathological features of 2 cases of PVF were analyzed and the relevant literatures were reviewed. Results：Two patients were female with an age of 8 and 39,respectively,and both had a tumor at the labia.The tumors were unilateral and ranged in a size of 4 cm and 5 cm in the maximum dimension.Histologically,the circumscribed lesion was located predominantly in the deep dermis with an extension to the subcutaneous tissue;it had a low cell density consisting of scattered spindle shaped fibroblast-like cells and a large amount of collagen fiber matrix;the tumor cells extended downward under the epithelium and infiltrated between the normal vascular,adipose and neural tissues.Cytologic atypia and mitotic figures were absent.Immunohistochemically,the spindle cells were uniformly positive for vimentin and CD34,but negative for SMA,desmin,CD99,S-100 protein and bcl-2;the adult part expressed positive for ER and PR. Conclusions：PVF is a benign mesenchymal lesion with a predilection for the vulva of prepubertal girls or women in rare cases.PVF may be the excessive proliferation of the vulva mesenchymal tissue,which may be related to the hormone;Some local recurrent cases might be induced by incomplete excision;however,spontaneous regression is occasionally observed.

关 键 词：外阴肿瘤 纤维瘤 青春期前 病理学 临床 诊断 鉴别 预后 

分 类 号：R737.35[医药卫生—肿瘤]