浅表性CD34阳性纤维母细胞肿瘤1例  

A case of superficial CD34-positive fibroblastic tumor

作　　者：吴嫣 赵丽娜 WU Yan;ZHAO Lina(Department of Pathology,Qianjiang Hospital Affiliated to Renmin Hospital of Wuhan University,Qianjiang Hubei 433100;Department of Pathology,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院潜江医院病理科,湖北潜江433100 [2]武汉大学人民医院病理科,武汉430060

出　　处：《临床与病理杂志》2023年第12期2213-2218,共6页Journal of Clinical and Pathological Research

摘　　要：为探讨浅表性CD34阳性纤维母细胞肿瘤(superficial CD34-positive fibroblastic tumor,SCPFT)的临床病理特征和诊断要点,本研究分析1例63岁老年女性SCPFT患者的临床病理资料,观察其组织学形态及免疫表型特征,并复习相关文献。患者因右上臂包块增大30年,疼痛2个月于2022年3月30日入院,行肿块切除术。标本在低倍镜下示肿瘤界限尚清,胖梭形肿瘤细胞呈片状、束状排列,细胞多形性明显,可见分叶的怪异核及核内假包涵体,间质内较多薄壁裂隙状血管,部分淋巴细胞及组织细胞浸润,核分裂象罕见。免疫表型:肿瘤细胞弥漫强阳性表达CD34,广谱细胞角蛋白(pan-cytokeratin,CKpan)灶状阳性,信号转导及转录激活因子6(signal transducer and activator of transcription 6,STAT-6)、结蛋白(Desmin)、平滑肌肌动蛋白(smooth muscle actin,SMA)、S-100、间变性淋巴瘤激酶(anaplastic lymphoma kinase,ALK)等阴性,Ki-67增殖指数约为2%。SCPFT是一种罕见的中间性肿瘤,具有独特的组织学形态及免疫表型,因其细胞多形性明显而易被误诊为其他软组织肉瘤,需密切结合临床病史及免疫表型以明确诊断。To investigate the clinical pathological features and diagnostic points of superficial CD34-positive fibroblastic tumor(SCPFT),this study aims to analyze the clinicopathological data of a 63-year-old female patient with SCPFT,observed its histological morphology and immunophenotypic features,and reviewed relevant literature.The patient presented with a gradually enlarging lump on the right upper arm for 30 years,with recent pain for 2 months,and was admitted to the hospital on March 30,2022,for tumor resection.Under low magnification,the specimen showed clear tumor boundaries with spindle-shaped tumor cells arranged in sheets and bundles,significant cellular pleomorphism,bizarre nuclei with pseudo-inclusions,numerous thin-walled cleft-like blood vessels in the stroma,occasional infiltration of lymphocytes and histiocytes,and rare mitotic figures.Immunophenotype analysis revealed diffuse strong positivity for CD34 and focal positivity for pan-cytokeratin(CKpan)in tumor cells,while signal transducer and activator of transcription 6(STAT-6),Desmin,smooth muscle actin(SMA),S-100,and anaplastic lymphoma kinase(ALK)were negative.The Ki-67 proliferation index was approximately 2%.SCPFT is a rare intermediate malignant tumor with unique histological morphology and immunophenotype.Due to its obvious cell pleomorphism,it can be misdiagnosed as other soft tissue sarcomas,necessitating close correlation with clinical history and immunophenotype for accurate diagnosis.

关 键 词：纤维母细胞肿瘤 CD34阳性 病理学 

分 类 号：R738.6[医药卫生—肿瘤]