孤立性纤维性肿瘤的临床及病理分析

Clinical and pathological analysis of solitary fibrous tumor

目的探讨孤立性纤维性肿瘤(SFT)的临床病理、免疫组化特征及鉴别诊断。方法报道一例肺的孤立性纤维性肿瘤,结合文献对本病的临床病理学特征进行探讨。结果临床主要表现为逐渐加重的胸闷、气急。X线胸片显示右下肺有一团块状阴影,边界清。肿瘤呈结节状,位于右下肺,紧靠肺膜下10cm×8cm×7cm,切面灰白,质嫩。镜下:肿瘤主要由短梭形细胞构成,有多种排列方式。免疫组化CD34阳性。结论SFT是一种少见的间质源性的梭形细胞肿瘤,须与多种其它梭形细胞肿瘤进行鉴别,免疫组化有助于鉴别诊断。约10%～30%的SFT具有恶性的生物学行为,表现为局部复发或远处转移,其组织构象并不能完全预测其预后,患者术后定期随访是必要的。

Objective To study the clinicopathologic and immunohistochemical features of solitary fibrous tumor（SFT） and its differential dignosis. Methods One case SFT of the lung was reported with emphasis on its clinicopathologic features and differential diagnosis, as well as review of the literatures. Results The main clinical manifestation was stifle and tachypnea. Chest-X-ray revenaled a pulmonary mass.The tumor was located in the right lower lobe of the lung,and well-circumseribed,measuring 10cm×8cm×7cm, pale in section. Microscopically, the tumor was composed of spindle cells arranged in different patterns.The immunohischemical analysis showed strong positivity of tumor cells to CD34. Conclusion SFT is a raremesencbymal spindle cell tumor which needs to be distinguished from other spindle cell tumors by differential diagnosis.The immunopbenotype can be help in this connection.About 10%-30% SFT have malignant behaviour.The behaviour of SFT is unpredictable,which requires careful,long-term follow-up.