66例皮肤纤维瘤临床与组织病理分析  

Clinical and histopathological analysis on 66 cases of dermatofibroma

作　　者：林冲 刘文辉 尚轶钒 刘林嶓[1] LIN Chong;LIU Wenhui;SHANG Yifan;LIU Linbo(Department of Plastic Surgery,The First Affiliated Hospital of Zhengzhou University,He’nan,Zhengzhou 450052,China;Department of Pathology,The First Affiliated Hospital of Zhengzhou University,He’nan,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院整形外科,河南郑州450052 [2]郑州大学第一附属医院病理科,河南郑州450052

出　　处：《中国现代医生》2022年第8期111-114,154,共5页China Modern Doctor

摘　　要：目的探讨皮肤纤维瘤(DF)的临床特征和组织病理特征,为临床诊治提供依据。方法回顾性分析2015年1月至2020年12月我院整形外科收治的皮肤纤维瘤66例患者(80个病灶)的临床和病理资料。结果66例皮肤纤维瘤患者,男女比例1∶1.13,中位发病年龄33.5岁,病程1个月~12年,肿瘤的大小从0.3~5 cm不等,多数肿瘤的大小≤2 cm(85.00%),部分患者有自觉症状,如瘙痒、触压痛等。80个病灶位于四肢者51例(63.8%),且下肢多于上肢,多表现为单发褐色结节。术前确诊“DF”12例,拟诊“梭形细胞瘤”2例、“隆突性纤维肉瘤”1例、“瘢痕”1例、“体表凹陷”1例、“肉芽肿”1例、“肌纤维母细胞瘤”1例。80张H-E染色切片中,细胞性2张(2.5%),动脉瘤样1张(1.25%),非典型性1张(1.25%),余均为经典型DF。免疫组化Vimentin、CD10均呈阳性,CD34阴性率为82.93%。结论不同分型的DF临床特点、病理表现和免疫组化结果存在一定差异,给诊断带来一定困难。掌握其临床和病理学特征是诊断的关键,结合免疫组化分析可避免误诊。Objective To explore the clinical features and histopathological characteristics of dermatofibroma(DF),so as to provide a basis for clinical diagnosis and treatmen.Methods The clinical and pathological data of 66 patients(with 80 lesions)with DF admitted to our plastic surgery department from January 2015 to December 2020 were retrospectively analyzed.Results The 66 patients with DF had a male-to-female ratio of 1:1.13,with a median age at disease onset of 33.5 years and disease duration of 1 month to 12 years.The tumor size ranged from 0.3 to 5 cm,and most tumors had a size of≤2 cm(85.00%).Some patients had subjective symptoms,such as pruritus,tenderness,etc.The 80 lesions were located in the four extremities in 51 cases(63.8%),with more lesions located in the lower extremities than in the upper extremities,and most of them were single brown nodules.Before surgery,12 cases were accurately diagnosed with DF,and 2 cases of suspected spindle cell tumor,1 case of suspected dermatofibrosarcoma protuberans,1 case of suspected scar,1 case of suspected depression on the skin surface,1 case of suspected granuloma,and 1 case of suspected myofibroblastoma were found.Of the 80 H-E stained sections,2(2.5 mm)were aneurysmal DF(2.5 mm)and 1(1.5 mm)were atypical DF(1.5 mm),and the remaining sections were all typical DF.Immunohistochemistry was positive for Vimentin and CD10,and the negative rate for CD34 was 82.93%.Conclusion The clinical features,pathological manifestations and immunohistochemical findings of DF of different types are somewhat different,which makes the diagnosis difficult.Mastering the clinical and pathological features of DF is the key to diagnosis,and combining with immunohistochemical analysis can help to avoid misdiagnosis.

关 键 词：皮肤纤维瘤 组织细胞瘤 组织病理 临床表现 

分 类 号：R739.5[医药卫生—肿瘤]