动脉瘤样皮肤纤维组织细胞瘤1例并文献复习  

Aneurysmal dermatofibroma:one case report and literature review

作　　者：李淑娟 杨新伟[1] 周林艳 LI Shujuan;YANG Xinwei;ZHOU Linyan(No.8 Surgery Departmen,Shanghai Municipal Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China;Pathology Department,Shanghai Municipal Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China)

机构地区：[1]上海中医药大学附属市中医医院外八科,上海200071 [2]上海中医药大学附属市中医医院病理科,上海200071

出　　处：《临床医学研究与实践》2024年第4期45-48,共4页Clinical Research and Practice

摘　　要：目的报道1例动脉瘤样皮肤纤维组织细胞瘤(ADF),并进行文献复习,以提高临床医师对该病的认识。方法归纳上海中医药大学附属市中医医院2021年9月28日收治的1例ADF患者的病历资料,对术中标本进行HE和免疫组化染色,记录并观察HE、免疫组化染色结果、治疗与随访情况。结果巨检显示灰黄组织3块,总直径0.8 cm。镜检显示真皮内结节状、不规则成片或成巢的梭形至卵圆形组织样细胞,内含有含铁血黄素颗粒和多灶性出血性囊腔、无内皮细胞内衬,为假血管性腔隙。免疫组织化学结果:CD34(-)、S-100(-)、Desmin(-)、SMA(-)、β-Catenin(-)、HMB-45(-);Vimentin(+)定位于细胞质和细胞核;CD68(+)定位于细胞膜和细胞质,呈棕黄色;Ki-67(5%+)定位于细胞核,呈棕黄色。患者术后随访1年未复发。结论ADF有一定的复发风险和交界恶性潜能,临床症状缺乏特异性,及时正确的诊断能使患者获益,治疗以尽早手术完整切除为主,后期建议定期随访。Objective To report a case of aneurysmal dermatofibroma(ADF),and to review the literature for improving the clinicians'understanding of the disease.Methods The medical records of one patient with ADF admitted in Shanghai Municipal Hospital Affiliated to Shanghai University of Traditional Chinese Medicine on September 28,2021 were summarized.HE and immunohistochemical staining were performed on the intraoperative specimens,and the results of HE and immunohistochemical staining,treatment and follow-up were recorded and observed.Results The gross examination showed 3 gray-yellow tissues with a total diameter of 0.8 cm.Microscopic examination showed nodular,irregularly formed or nesting spindle to oval histoid cells in the dermis,containing yellow particles containing iron blood,multifocal hemorrhagic cysts and no endothelial cell lining,which was pseudovascular lacunae.Immunohistochemical results:CD34(-),S-100(-),Desmin(-),SMA(-),β-Catenin(-),HMB-45(-);Vimentin(+)was localized in cytoplasm and nucleus;CD68(+)was located in the cell membrane and cytoplasm,showing brownish yellow;Ki-67(5%+)was located in the nucleus,showing brownish yellow.The patient was followed up for 1 year without recurrence.Conclusion ADF has a certain risk of recurrence and borderline malignant potential,the clinical symptoms lack specificity,and timely and correct diagnosis can benefit patients.The treatment is mainly complete resection as soon as possible,and regular follow-up is recommended later.

关 键 词：动脉瘤样皮肤纤维组织细胞瘤 表皮囊肿 鉴别诊断 

分 类 号：R732.21[医药卫生—肿瘤]