腹腔脏器炎性肌纤维母细胞瘤的临床病理观察

Inflammatory myofibroblastic tumor of abdominal viscera:a clinicopathological stuty

目的探讨腹腔脏器炎性肌纤维母细胞瘤(inflammatorymyofibroblastictumor,IMT)的临床病理特征、组织发生和预后。方法分析10例IMT的临床病理学资料,所有病例行HE染色和免疫组化染色。结果腹腔脏器IMT的组织学分为三型:(1)黏液样-血管型,(2)梭型细胞密集型,(3)少细胞纤维瘢痕型。肿瘤细胞表达vimentin、SMA、MSA、CKpan和ALK,其阳性率分别为100%、90%、90%、60%和20%。10例IMT中有5例做了根治性切除术,另有5例单纯肿瘤切除,随访无1例复发。结论腹腔脏器IMT易被临床医师误诊为晚期癌。免疫组化表型是该肿瘤与其他软组织肿瘤鉴别的重要依据。腹腔脏器IMT一般具有良性病变的生物学行为,根治性手术可能治愈。

Purpose To explore the clinicopathologic feature,histogenesis and prognosis of inflammatory myofibroblastic tumor （IMT） in abdominal viscera. Methods To analyze the clinical and pathological date of 10 cases abdominal viscera IMT. All cases were done by HE stain and immunohistochemical markers. Results There were three basic histological pantterns of abdominal vicera IMT： （ 1 ） myxoid-vascular panttern, （2） companct spindle cell panttern, （3）hypocellular-fibroscar panttern. Tumor cells expressed vimentin, SMA, MSA, CKpan, ALK, the positive rates were 100% , 90% , 90% , 60% , 20% respectively. Among the 10 ceses of abdominal viscera IMT, 5 cases had redical excision, other 5 cases had simple tumor excision. These cases were followed up without recurrence. Conclusions It is easy that abdominal IMT was diagnosed mistakenly as late carcinoma by clinician. Immunohistochemical phenotype was an important evidence to differentiate IMT from another soft tissue tumors. Abdominal viscera IMT generally behaves as benign lesions and are possibly cured by radical excision.