肺内多发性孤立性纤维性肿瘤临床病理观察  

Intrapulmonary multiple solitary fibrous tumor: clinical and pathological analyses

作　　者：龙琼先[1,2] 吴才良[1,2] 唐治蓉[1,2] 刘欣雅[1,2] 

机构地区：[1]川北医学院第二临床医学院 [2]南充市中心医院病理科,四川南充637000

出　　处：《诊断病理学杂志》2015年第3期150-152,155,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨肺内多发性孤立性纤维性肿瘤的临床病理特点及鉴别诊断。方法对1例肺内多发性孤立性纤维性肿瘤进行临床、病理学观察及免疫组化检测,结合文献探讨其发生、诊断与鉴别诊断及预后。结果患者男性,52岁。CT示左胸下部可见软组织团块。大体示肺组织切面见弥漫分布的多个结节,最大者直径5 cm,最小者直径0.5 cm。镜下见肿瘤组织由梭形细胞构成,排列成束状和编织状,细胞形态似纤维母细胞,核分裂象2个/10HPF,胶原化的纤维间质较少。免疫组化示CD34、CD99和vimentin(+),PCK、S-100、SMA、CD117和D2-40(-)。结论肺内多发性孤立性纤维性肿瘤罕见,由于其大体表现特殊,容易误诊为其他梭形细胞肿瘤,免疫组化检测有助于其诊断及鉴别诊断。Objective To explore the clinical and pathological features and main diagnostic points of intrapulmonary multiple solitary fibrous tumor. Methods The clinical data,pathological and immunohistochemical features were analyzed in one case of intrapulmonary multiple solitary fibrous tumors,and its diagnosis and differential diagnosis were explored with review of the recent literature. Results The patient was a 52-year-old male. CT showed a soft tissue mass located in left lower chest. Gross findings showed multiple nodules in lung tissue,the nodules ranged in size from 0. 5 to 5 cm.Microscopically,the tumor was composed of spindle cells,arranged in bundles and braided. Cellular morphology was similar to fibroblasts,mitotic figures were 2 /10 HPF. There were a little collagen fibers in interstitial tissue. Immunohistochemistry showed the tumor cells were positive for CD34,CD99 and vimentin,and negative for PCK,S-100,SMA. Conclusion The intrapulmonary multiple solitary fibrous tumor is rarely found. As for the special gross features,the tumor may be misdiagnosed as other spindle cell tumors. The immunohistochemistry contributes to its diagnosis and differential diagnosis.

关 键 词：肺肿瘤 孤立性纤维性肿瘤 病理学 免疫组化 

分 类 号：R734.2[医药卫生—肿瘤]