血管瘤样纤维组织细胞瘤6例临床病理分析  

Angiomatoid fibrous histiocytoma: 6 cases of report and review of literature

作　　者：武彤彤[1] 胡维维[2] 杨清绪[1] 赖日权[3] 

机构地区：[1]惠州市中心人民医院病理科,516000 [2]佛山市第一人民医院病理科,528000 [3]广州军区广州总医院病理科,510010

出　　处：《临床与实验病理学杂志》2013年第7期761-764,共4页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的探讨血管瘤样纤维组织细胞瘤(angiomatoid fibrous histiocytoma,AnFH)临床病理特征与鉴别诊断。方法采用免疫组化SP法对6例AnFH进行染色,并复习相关文献。结果 6例AnFH中女性4例,男性2例;年龄7～60岁,中位年龄23.5岁;病变位于下肢4例,上肢1例,背部1例。肿瘤直径0.8～3.5 cm,切面灰白色、灰红棕色,5例见小囊腔,囊内含血性,呈血肿样或血管瘤样。镜下见细胞样细胞和肌样细胞呈结节状增生,瘤细胞大小相对一致,核椭圆,空泡状,分化好;假血管瘤样腔隙,囊腔内充满红细胞,但囊壁缺乏血管内皮细胞;瘤结外围被致密纤维组织包绕,伴淋巴细胞和浆细胞浸润,偶见具有生发中心的淋巴滤泡形成。免疫表型:vimentin阳性,5例desmin、CD99和CD68阳性,2例EMA阳性,而CK、S-100蛋白、CD34、Myogenin、HMB-45、CD21、CD23和CD35均阴性。4例随访6个月～4年,仅1例复发,未发生转移,患者均健在。结论AnFH为较少见的低度恶性肿瘤,多见于儿童和青少年。病理诊断时若形态缺乏扩张的假血管样腔隙时易与其他肿瘤混淆,如动脉瘤性纤维组织细胞瘤、未分化多形性肉瘤、淋巴结转移性癌、滤泡树突状细胞肉瘤等。熟悉其形态特征,对避免误诊为其它类似病变具有重要的意义。Purpose To study the clinicopathologic feature and differential diagnosis of angiomatoid fibrous histiocytoma （AnFH）. Methods 6 cases AnFH were stained by using SP method of immunohistoehemistry, and the literature was reviewed. Results A- mong 6 cases of AnFH, there were 4 males and 2 females with an age range from 7 to 60 years （ median 23.5 years）. There were 4 ea- ses in lower limbs and 1 case in upper limbs, and 1 case in trunk. The tumor diameter was ranging from 0.8 to 3.5 era. The cut sur- face is tan to brown and either contains cystic spaces, which are filled with fresh or clothed brood, or has solid hemorrhagic foci. The distinctive histopathology were： AnFH consists of nodular mass surrounded by dense a fibrous pseudocapsule and intermingled with chronic inflammatory cell. The nodular contains whorls or fascicles of plump spindle cell that nests of myofibroblast-like and histiocyte like cell. Cystic change lack endothelial lining filled with hemorrhagic fluid blood. Immunohistochemieal study showed that 6 cases were positive for vimentin, 5 cases for desmin, CD99, CD68 and 2 cases for EMA were positive, and negative for CK, S-100, CD34 Myogenin, HMB-45, CD21, CD23 and CD35. 4 cases were followed up, only 1 case was local recurrence and 3 cases without recur- rence and metastases. Conclusion AnFH is a rare low-grade soft tumor with slowly growing, recognizing its morphological character is important to avoid confusion with other similar lesions.

关 键 词：纤维组织细胞瘤 血管瘤样 病理学 外科 免疫组织化学 

分 类 号：R730.26[医药卫生—肿瘤] R732.2[医药卫生—临床医学]