浅表性CD34阳性纤维母细胞瘤1例并文献复习  

Superficial CD34 positive fibroblastic tumor:A case report and literature review

作　　者：巫永志 张琴琴 孙国敏 毛国梁 李佳嘉[1] 徐国祥[1] 刘银华[1] WU Yongzhi;ZHANG Qinqin;SUN Guomin;MAO Guoliang;LI Jiajia;XU Guoxiang;LIU Yinhua(Department of Pathology,Yijishan Hospital,Wannan Medical College,Wuhu Anhui 214001,China)

机构地区：[1]皖南医学院弋矶山医院病理科,安徽芜湖241001

出　　处：《临床与病理杂志》2022年第6期1496-1504,共9页Journal of Clinical and Pathological Research

基　　金：安徽高校自然科学研究重点项目(KJ2018A0250);皖南医学院弋矶山医院科研能力“高峰”培育计划项目(GF2019G19)。

摘　　要：通过收集患者的临床信息、对送检组织行HE切片、免疫组织化学染色及基因检测观察,综合相关文献总结浅表性CD34阳性纤维母细胞瘤(superficial CD34 positive fibroblastic tumor,SCPFT)的临床病理特征、免疫组织化学和与其他疾病的鉴别诊断特点。患者男,54岁,于2个月前无意中发现右下腹部包块1枚,切除肿块行组织活检,肿块边界清,无包膜,镜下肿块位于真皮深层,边界相对清楚,肿瘤由梭形细胞、胖梭形细胞及多边形细胞组成,呈束状或片状排列,局部可见奇异形或多形性细胞核,部分瘤细胞细胞质呈空泡状及黄色瘤样;核分裂罕见,间质内淋巴细胞散在或局灶浸润;免疫组织化学:CD117(-)、CD34(+)、CD68(少数+)、Desmin(灶区+)、SMA(-)、β-catenin(细胞质+)、MyoD1(-)、Ki-67(1%+),荧光原位杂交技术(fluorescence in situ hybridization,FISH)检测出PRDM10易位。浅表性CD34阳性纤维母细胞瘤是一类新报道的纤维母细胞肿瘤的新亚型,其典型的特点为CD34弥漫阳性,但组织学形态与其他间叶性肿瘤有较多的相似之处,需要结合PRDM10基因易位与非典型性黄色纤维瘤、上皮样肉瘤和其他软组织肿瘤所鉴别,提高对该疾病的认识并准确诊断出该类疾病,对临床治疗至关重要。By collecting the clinical information of the patient,performing HE slides,immunohistochemistry and gene detection of the tissue,and combining the relevant literature,we summarized the clinical features,immunohistochemistry and differential diagnosis of superficial CD34 positive fibroblastic tumor(SCPFT)from other diseases.A 54-year-old male patient with a right abdomen mass was found by accident.The tumor was resected and biopsied.The boundary of the mass was clear and there was no capsule.Under the microscope,the mass was located in the deep dermis.The boundary of tumor was relatively clear,and it was composed of spindle cells,fat spindle cells and polygonal cells,which were arranged in bundles or sheets.There were some areas full of bizarre or polymorphic nuclei.The cytoplasm of some tumor cells is vacuolated and xanthoma-like.But mitosis was rare.Lymphocytes were scattered or focally infiltrated in stroma.Immunohistochemistry:CD 117(-),CD34(+),CD68(few+),desmin(focal area+),SMA(-),β-catenin(cytoplasm+),MyoD1(-),Ki-67(1%+),fluorescence in situ hybridization(FISH)showed PRDM10 translocation.Superficial CD34 positive fibroblastic tumor is a new subtype of fibroblastic tumor discovered.The typical characteristic is CD34 diffuse positive,but the histological morphology is similar to other mesenchymal tumors,so with the help of the PRDM10,we can distinguish SCPFT from atypical fibroxanthoma(AFX),epithelioid sarcoma(ES)and other soft tissue tumors.Improving the understanding of the disease and ascertaining accurately diagnose of the disease are essential for clinical treatment.

关 键 词：纤维母细胞瘤 CD34阳性 PRDM10 免疫组织化学 鉴别诊断 

分 类 号：R730.26[医药卫生—肿瘤]