摘要
目的探讨深部血管粘液瘤(deep angiomyxoma,DAM)与血管肌纤维母细胞瘤(angiomyofibroblastoma,AMF)的临床病理特点、免疫表型、病理诊断和鉴别诊断要点。方法收集女阴部6例DAM和8例AMF,分析其临床特点,观察病理组织学形态及免疫表型特征,并复习相关文献。结果 6例DAM患者年龄39~56岁,平均48.2岁,8例AMF患者年龄21~50岁,平均40.8岁。14例均表现为真皮深层或皮下缓慢生长肿块,术后随访时间2个月~8年,6例DAM中3例于术后半年到2年复发,8例AMF无复发。组织学上DAM瘤细胞呈弥漫性或结节性分布,丛状分布的血管壁厚薄不均,厚壁血管常玻璃样变性,见"袖套状"结构。AMF瘤细胞呈典型的疏密交替,密集区瘤细胞围血管分布,血管小,常为毛细血管,无厚壁血管和"袖套状"结构。结论 DAM和AMF均为纤维母-肌纤维母细胞源性肿瘤,好发于女阴部,二者的组织学形态存在重叠,免疫表型也相似,但预后方面存在区别,应予以认识和鉴别。
Objective To study the clinicopathological features,immunophenotype and differential diagnosis of deep angiomyxoma(DAM) and angiomyofibroblastoma(AMF) . Methods The clinicopathological features of 6 cases of DAM and 8 cases of AMF in vulva were analyzed. Immunohistochemical study was carried out and the literature was reviewed. Results The average age of 6 cases of DAM patients was 48.2 years old. The average age of 8 cases of AMF was 40.8 years old. All the patients primarily presented with a slowly enlarging painless deep dermal or subcutaneous mass. All the patients underwent complete resection of the tumor. During a period of follow up for 2 months to 8 years,3 cases of DAM had recurrence,however,8 cases of AMF had no recurrence. Histologically,DAM was a locally infiltrative tumor composed of fibroblasts,myofibroblasts and numerous,characteristically thick-walled,blood vessels embedded in an abundant myxoid matrix. The abundant myxoid matrix contained a variable number of rounded medium-sized to large vessels that possessed thickened focally hyalinized walls. AMF was composed of spindle-shaped to round cells that tended to concentrate around vessels,which showed alternating hypercellular and hypocellular areas associated with a prominent vascular pattern throughout. Conclusions DAM and AMF are all from fibroblast-myofibroblast that occurs mainly in vulva. DAM and AMF have the similar histological features,immunophenotype and differential prognosis. It is important to pay more attention to the pathological diagnosis and differential diagnosis of the two tumors.
出处
《临床医学工程》
2010年第12期52-54,共3页
Clinical Medicine & Engineering