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目的分析孤立性纤维性肿瘤的临床表现、病理形态学及免疫组织化学特点。方法收集孤立性纤维性肿瘤8例,对其临床、病理及免疫组织化学资料进行分析及文献复习。结果本组病例女性5例,男性3例,年龄31～62岁,平均45.3岁。发生部位包括纵隔、鼻腔、腮腺、口腔、眼眶等。临床主要表现为局部肿块及其引起的压迫症状。主要病理学改变:肿瘤直径1.5～25.0cm,大部分边界清楚,表面包膜完整;镜下瘤细胞呈梭形、短梭形,细胞质红染,核圆形、卵圆形,无异型性,核分裂象少见,细胞排列呈束状、编制状、漩涡状、席纹状或不规则状,可见大量胶原纤维,瘤细胞可分布于其间,间质部分玻璃样及黏液变性,散在炎细胞浸润。免疫组织化学结果:vimentin阳性8例,CD34阳性7例,bcl-2阳性6例,CD99阳性7例,SMA阳性4例,S-100阳性1例。结论孤立性纤维性肿瘤可发生在全身各部位。大多数是良性梭形细胞肿瘤,结合临床特点和病理镜下表现以及免疫组化能做出准确诊断,少数有低度恶性可能,表现为局部复发或远处转移,其组织学构像并不能完全精确的预测其预后,患者术后的定期随访是必要的。
Objective To analyze the clinical manifestations, pathomorphology and immunohistochemical features of solitary fibrous tumors. Methods Eight cases of solitary fibrous tumor were collected. The clinical, pathological and immunohistochemical data were analyzed and the literature review was conducted. Results This group of 5 female patients, 3 males, aged 31 to 62 years, mean 45.3 years old. Occurred sites include the mediastinum, nasal cavity, parotid gland, mouth, eyes and so on. The main clinical manifestations of local mass and caused by oppression symptoms. The main pathological changes: tumor diameter 1.5 ~ 25.0cm, most of the border is clear, the surface envelope integrity; microscopic tumor cells were spindle, short fusiform, cytoplasmic red staining, nuclear round, oval, no atypia, Schizosaccharomyces were rare, the cells arranged in the shape of a bundle, the preparation of the shape, whirlpool, satin stripes or irregular shape, showing a large number of collagen fibers, tumor cells can be distributed in the meantime interstitial glassy and mucus degeneration, scattered in inflammatory cell infiltration. Immunohistochemistry results: 8 cases of vimentin positive, 7 cases of CD34 positive, 6 cases of bcl-2 positive, CD99 positive in 7 cases, SMA positive in 4 cases, S-100 positive in 1 case. Conclusion Solitary fibrous tumors can occur in all parts of the body. Most are benign spindle cell tumors, combined with clinical features and pathological microscopic findings and immunohistochemistry to make accurate diagnosis, a small number of low-grade possible malignancy, manifested as local recurrence or distant metastasis, the histological conformation and can not Accurately predict the prognosis of patients with regular follow-up after surgery is necessary.