孤立性纤维性肿瘤临床病理分析

Solitary fibrous tumor: a clinicopathologic analysis

目的探讨孤立性纤维性肿瘤的病理学特征、组织来源及鉴别诊断。方法对3例孤立性纤维性肿瘤进行临床病理分析,并应用CD34、Vim、bcl2、actin、Des、CD68、S100以及MG抗体进行免疫组化染色。结果镜下见肿瘤组织由不同比例的纤维母细胞和胶原构成,纤维母细胞分化良好,形态多样,散乱穿梭于胶原蛋白束之间或环绕在玻璃样变的血管周围,伴有局灶性致密区域;胶原成分发生玻璃样变,局部呈轮辐状或瘢痕状排列。免疫组化染色示CD34、Vim、CD99及bcl2(+),余均(-)。结论孤立性纤维性肿瘤是一种少见的良性肿瘤,可以根据病理形态学及免疫组化来加以诊断和鉴别诊断。

Objective To explore the pathological characteristics, origin and differential diagnosis of the solitary fibrous tumor. Methods Three eases of solitary fibrous tumour were analyzed by histological observation and immunohistochemieal staining of CD34, Vim, CD99, Bcl-2, Aetin, Des, CD68, S100 and MG. Results Histologically, the tumor was composed of mildly cellular benign-appearing spindle-shaped cells and bands of hyalinized collagen in varying proportions from area to area, and a typical pattemless architecture： the lesion showed a disorganized arrangement of spindle cells （presenting a storiform, fascicularor or spiral pattern in some areas） in a extensive eollagenous background （dense hyalinized areas, presenting spoke or keloid-like pattern. ） and prominent vascular channels of varying size. Turnout cells were strongly immunoreaetive to CD34, CD99, vimentin and Bcl-2, but negative to S100 protein, aetin, desmin, DG and so on. Conclusion Solitary fibrous tumor is a rare and benign tumor, and can be diagnosed by histological and immunohistochemical findings.