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目的 探讨树突状纤维黏液脂肪瘤的临床病理特征 ,并讨论与其他易于混淆的软组织肿瘤的鉴别诊断。方法 收集 8例树突状纤维黏液脂肪瘤 ,观察和分析其临床和病理组织学特征 ,并通过免疫组织化学标记链霉素卵白素生物素 (LSAB)法 ,分析其CD34、bcl 2、波形蛋白、细胞角蛋白(CK)、上皮膜抗原 (EMA)、S 10 0、HHF35和平滑肌肌动蛋白 (SMA)等的表达。结果 该肿瘤主要见于中老年男性皮下软组织或肌筋膜 ;主要分布在颈、背、肩及小腿 ,也可见于面部和足部。大体上边界清楚或有薄包膜 ,切面部分呈黏液样或胶冻状。该肿瘤在组织形态学上以成熟脂肪组织、增生的梭形细胞或星状细胞、黏液样及纤维化间质等为主要成分 ,在不同区域以不同的比例混杂构成。梭形细胞或星状细胞伸出细长分枝状胞质突起是其形态特征之一。无细胞异型性和核分裂象。此外 ,该肿瘤常有较丰富的丛状小血管和毛细血管 ,间质有肥大细胞、小淋巴细胞及浆细胞浸润。免疫组织化学染色梭形细胞显示CD34、bcl 2和波形蛋白强阳性 ,而HHF35、SMA和S 10 0阴性 ,肿瘤中所有成分对CK和EMA呈阴性反应。结论 树突状纤维黏液脂肪瘤在临床表现、病理组织学改变以及免疫组织化学反应等方面有其独自的特点。该肿瘤似乎是介于梭形细胞脂肪瘤和软组织孤立性纤维
Objective To investigate the clinicopathological features of dendritic fibrous myxo lipoma and to discuss the differential diagnosis with other easily confused soft tissue tumors. Methods Eight cases of dendritic fibrous myxomatous lipoma were collected. The clinical and histopathological features were observed and analyzed. The expression of CD34, bcl 2, vimentin , Cytokeratin (CK), epithelial membrane antigen (EMA), S 10 0, HHF35 and smooth muscle actin (SMA). Results The tumor was mainly found in the subcutaneous soft tissue or myofascial of the middle-aged and elderly men. It mainly distributed in the neck, back, shoulders and lower legs, and also in the face and feet. In general the border is clear or thin envelope, part of the section was mucoid or jelly-like. The tumor morphology in the mature adipose tissue, hyperplastic spindle cells or stellate cells, myxoid and fibrotic interstitial as the main component in different regions mixed with different proportions. Spindle cells or stellate cells protruding slender branched cytoplasmic protrusions is one of its morphological characteristics. Acellular and mitotic figures. In addition, the tumor often has more abundant plexiform blood vessels and capillaries, interstitial mast cells, small lymphocytes and plasma cells infiltration. Immunohistochemical staining of spindle cells showed strong positive for CD34, bcl2 and vimentin, while negative for HHF35, SMA and S10o, with all components of the tumor negative for CK and EMA. Conclusions Dendritic fibrous myxo lipoma has its own characteristics in clinical manifestations, histopathological changes and immunohistochemical reactions. The tumor appears to be between spindle cell lipoma and soft tissue isolated fibers