韧带样纤维瘤误诊临床分析  

Misdiagnosed Analysis of 3 Patients with Desmoplastic Fibroma

作　　者：韩猛虎 姜合作 王文璋 李基业 HAN Meng-hu;JIANG He-zuo;WANG Wen-zhang;LI Ji-ye(Department of General Surgery,Hebei Yanda Hospital,Sanhe,Hebei 065201,China;Department of Thoracic Surgery,Hebei Yanda Hospital,Sanhe,Hebei 065201,China)

机构地区：[1]河北燕达医院普外科,河北三河065201 [2]河北燕达医院胸外科,河北三河065201

出　　处：《临床误诊误治》2021年第9期18-23,共6页Clinical Misdiagnosis & Mistherapy

摘　　要：目的探讨韧带样纤维瘤的临床特点及误诊原因、防范措施。方法对2019年1—12月收治的曾误诊的韧带样纤维瘤3例的临床资料进行回顾性分析。结果本文1例因右上肢放射性疼痛3个月,发现右侧胸壁肿物2个月入院,曾误诊为炎性肌纤维母细胞瘤;1例因腹部肿物多次切除术后复发18年入院,曾误诊为恶性神经鞘瘤;1例因发现腹腔内肿物3个月入院,曾误诊为胃间质瘤。3例入院后均经多学科医师会诊,给予手术治疗,术后病理及免疫组织化学检查明确诊断韧带样纤维瘤,术后皆恢复良好,现尚在随访中,均无不适,无复发。结论韧带样纤维瘤临床误诊率高,病理及免疫组织化学检查可明确诊断。临床医师应加强对其认识,认真鉴别诊断,以减少或避免该病误诊误治。Objective To investigate clinical characteristics,misdiagnosed causes and preventive measures of desmoplastic fibroma.Methods Clinical data of 3 misdiagnosed patients with desmoplastic fibroma admitted between January 2019 and December 2019 was retrospectively analyzed.Results One patient was admitted for radiating pain in the right upper limb for 3 months and a mass detected on the right chest wall for 2 months,and the patient was misdiagnosed as having inflammatory myofibroblastoma.One patient was admitted for 18 years of repeated recurrence after resections of an abdominal mass for many times,and the patient was misdiagnosed as having malignant schwannoma.One patient was admitted for finding an abdominal mass for 3 months,and he was misdiagnosed as having gastric interstitial tumor.The 3 patients underwent multidisciplinary consultations after admission and surgical treatments,and desmoplastic fibroma was confirmed by postoperative pathological and immunohistochemical examinations.All patients recovered well after surgical treatments.The patients are still under follow-up till now,and there was no discomfort or recurrence.Conclusion The misdiagnosis rate of desmoplastic fibroma is high in clinical practice,and postoperative pathological and immunohistochemical examinations may confirm the diagnosis.Clinicians should strengthen understanding of the disease and carefully differential diagnosis in order to reduce or avoid misdiagnosis and mistreatment.

关 键 词：韧带样纤维瘤 误诊 肿瘤 肌组织 神经鞘瘤 间质瘤 

分 类 号：R730.262[医药卫生—肿瘤]