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目的探讨促结缔组织增生性纤维母细胞瘤(DF)的临床及病理学特征。方法对4例DF的临床特点、常规HE进行形态观察,同时应用免疫组织化学方法进行免疫表型的分析及复习相关文献。结果病变位于下肢皮下组织,以足部多见,肿瘤呈无痛性缓慢生长,呈良性经过,切除后无复发;镜下:肿瘤由稀疏的梭形或星状纤维母细胞和大量致密的胶原纤维构成,部分病例局灶性纤维黏液样变;瘤细胞核染色质细致,可见明显小核仁,细胞无异型性,也无核分裂象,未见肿瘤性坏死、钙化及骨化现象,部分病变局灶性血管增生;免疫组织化学标记显示瘤细胞弥漫性强表达波形蛋白,局灶性表达平滑肌肌动蛋白及肌特异性肌动蛋白。结论DF是一种具有独特临床病理学特征的良性纤维母细胞性或肌纤维母细胞性肿瘤,形态学与免疫表型存在肌纤维母细胞特征性的fibronexus junctions结构和纤维母细胞相关特征的超微结构表现;组织学上应与其他一些良性或具有局部复发潜能或低度恶性的纤维母细胞性或肌纤维母细胞性病变相鉴别。
Objective To investigate the clinical and pathological features of connective tissue proliferating fibroblastoma (DF). Methods The clinical features of 4 cases of DF and routine HE were observed. Immunohistochemical method was used to analyze the immunophenotype and review related literature. Results The lesions were located in the subcutaneous tissue of the lower extremities. Most of the feet were seen. The tumors grew painlessly and showed a benign course. There was no recurrence after resection. Microscopically, the tumor consisted of sparse fusiform or stellate fibroblasts and a large number of dense collagens. Fibrous composition, focal fibrosis in some cases; fine nuclear chromatin in the tumor, visible small nucleoli, no atypical cells, no mitotic figures, no necrotic, calcified and ossification, and some lesions Focal angiogenesis; immunohistochemical staining showed strong expression of vimentin in tumor cells, focal expression of smooth muscle actin, and muscle-specific actin. Conclusion DF is a benign fibroblast or myofibroblastoma with unique clinicopathological characteristics. There are fibronoblast junctions and fibroblast-related ultrastructural characteristics characteristic of myofibroblasts in morphology and immunophenotype. Histology should be differentiated from other benign or fibroblast or myofibroblastic lesions with local recurrence or low grade of malignancy.