15例成人炎性肌纤维母细胞肿瘤的临床观察  

Clinical observation of adult inflammatory myofibroblastic tumor in 15 cases

作　　者：宋玮 朱岩 SONG Wei;ZHU Yan(Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China)

机构地区：[1]南京医科大学第一附属医院呼吸与危重症医学科,南京210029 [2]南京医科大学第一附属医院病理科,210029

出　　处：《临床肿瘤学杂志》2020年第11期1022-1026,共5页Chinese Clinical Oncology

摘　　要：目的探讨成人炎性肌纤维母细胞肿瘤(IMT)的临床病理特征、诊断及治疗。方法回顾性分析2010年7月至2019年2月15例成人IMT患者的临床资料,对临床病理特征、治疗及预后进行分析。结果15例患者中,男性11例,女性4例;病变发生于肺部8例,结肠、膀胱各2例,肠系膜、胃、腹膜腔各1例。5例体检发现,其余因病变部位疼痛、出血或出现肿块就诊。影像学表现主要为团块样肿块。除1例上皮样炎性肌纤维母细胞肉瘤(EIMT)患者死亡外,余14例均接受手术切除。免疫组化检测显示,ALKp80(11/15)、SMA(10/15)、CKp(4/15)和Des(3/15)阳性表达。随访18~114个月,2例患者复发,其余12例术后无瘤生存。结论IMT具有潜在或低度恶性,EIMS为IMT的高度侵袭性罕见亚型,IMT症状及影像学缺乏特异性,一旦确诊,根治性手术为首选治疗。Objective To explore the clinical and pathological characteristics,diagnosis and treatment in adult inflammatory myofibroblastic tumor(IMT).Methods Fifteen cases of adult inflammatory myofibroblastic tumor from July 2010 to February 2019 were confirmed.Clinical characteristics,pathological features,treatment and prognosis were analyzed,retrospectively.Results Among the 15 patients,there were eleven males and four females with a mean age of 37.2 years old.The most common locations were bronchus and lungs(8 cases),followed by colon and bladder(2 cases each),mesenterium,stomach and peritoneal cavity(1 case each).Five patients were found to have mass through physical examination,and the rest 10 cases were with the symptoms of pain,bleeding and lumps.The main imaging findings were mass.One patient of epithelial inflammatory myofibroblast sarcoma(EMIT)died,and the rest 14 cases underwent surgery.Immunohistochemical staining showed the tumor cells exhibited positive staining for ALKp80(11/15),SMA(10/15),CKp(4/15)and Des(3/15).The follow-up time was 18-114 months.Two cases relapsed and the other 12 cases were cured.Conclusion IMTs are potential malignancy or low-grade.EIMS is a rare and highly invasive variant of IMT.The clinical and imaging manifestation are lack of specificity,and radical surgery is the first choice once confirmed by pathology.

关 键 词：炎性肌纤维母细胞肿瘤(IMT) 免疫组织化学 上皮性炎性肌纤维母细胞肉瘤(EMIT) 

分 类 号：R730.262[医药卫生—肿瘤]