骨化性纤维黏液样肿瘤临床病理观察及文献复习  

Clinicopathologic feature of ossifying fibromyxoid tumor and reviews of literature

作　　者：崔华娟[1] 赖日权[1] 王卓才[1] 彭大云[1] 陈敬文[1] 

机构地区：[1]广州军区广州总医院病理科,广州510010

出　　处：《临床与实验病理学杂志》2013年第7期757-760,共4页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的提高对软组织骨化性纤维黏液样肿瘤(ossifying fibromyxoid tumor,OFT)的认识。方法对4例OFT采用光镜观察及EnVision两步法免疫组化标记,并结合文献对其良恶性进行讨论。结果 4例OFT均为中年男性,平均年龄43.5岁。临床表现为四肢皮下缓慢生长的肿块。3例肿瘤镜下境界清楚,有一层厚的纤维性假包膜围绕,包膜内可见一层薄的不连续性骨壳,由成熟的化生性板层骨组成;肿瘤实质由多个大小不一的小叶组成,小叶内瘤细胞呈特征性巢状、条索状或纤细网格状排列,肿瘤间质呈黏液样。瘤细胞呈上皮样圆形、卵圆形或短梭形,细胞境界较清楚,胞质淡染或嗜酸性。3例核染色质细致,核分裂象偶见(<2个/50 HPF);1例表面仅见无骨壳的纤维性包膜,肿瘤中心见不规则骨样基质,细胞密度增高,胞核有异型,核分裂>2个/50 HPF。免疫组化结果显示瘤细胞均表达vimentin(4/4),多数表达S-100蛋白(3/4),部分表达desmin、CD56及CKpan。3例典型OFT随访12～38个月未复发,1例非典型/恶性OFT术后18个月复发。结论 OFT是一种好发于中老年人的软组织肿瘤,具有一定的组织形态学特征,需与神经鞘膜瘤、皮肤混合瘤及低度恶性纤维黏液样肉瘤鉴别。Purpose To increase the recognition of soft tissue＇ s ossifying fibromyxoid tumor （OFT）. Methods The clinopathological and EnVision immunohistoehemical features of four uncommon cases of OFT was described and some relevant literatures were reviewed. Results All four cases occurred in adult male patients with an average age of 43.5 years. Clinically, the majority presented as slowly growing painless masses that located in subeutis of the extremities. Histologically, 3 cases were well circumscribed and encapsulated with an incomplete bony shell composed of metaplastic bone within the capsule. The tumor parenchyma was consisted of lobules of vari- able size and cellularity. The tumor cells arranged in nests, cords, or reticulation pattern, and were embedded in a characteristic fibro- myxoid and/or eollagenized stroma. The tumor cells of each lobule were rounded to short spindled with pale-staining or eosinophilic cy- toplasm. The cell nucleus of three cases have slight chromatin and mitoses were less than 2 per 50 high power field （HPF）. One case was circumscribed and encapsulated without an incomplete bony shell and has irregularly osteoid tissue in the center of tumor. The tumor have high cellularity and cell nucleus heteromorphism, mitoses were more than 2 per 50 HPF. Immunohistoehemically, tumor cells were positive for vimentin （4/4） and S-100 protein （3/4） and partial cases expressed desmin, CD56 and CKpan. Three cases were followed up with twelve months to thirty-eight months but not recurred, while one case recured after eighteen months. Conclu- sions OFT is a distinctive soft tissue tumor of potentially low-grade malignancy which occurred predominantly in middle to old aged patients and should been differentiated from schwannoma, cutaneous mixed tumors and low-grade fibromyoid sarcomas.

关 键 词：骨化性纤维黏液样瘤 软组织 恶性 免疫组织化学 

分 类 号：R738.6[医药卫生—肿瘤]