乳腺结节性筋膜炎1例及文献复习

Nodular fasciitis of the breast:1 case report and literature review

目的探讨乳腺结节性筋膜炎的临床病理特征。方法对1例乳腺结节性筋膜炎的临床表现、组织形态和免疫表型进行研究,并文献复习。结果该例肿块3cm×2cm,边界不清,向周围乳腺及脂肪组织浸润。肿块主要由梭形细胞组成,其中含少量破骨样巨细胞。梭形细胞表达Vim、SMA和MSA,破骨样巨细胞表达CD68(KP-1),未发现CK阳性细胞。结论结节性筋膜炎很少复发,也不转移,组织学形态易与一些良恶性肿瘤混淆,需做免疫组化检测以明确其性质。

Purpose To discuss the clinicopathological features in nodular fasciitis of the breast. Methods The clinical expressions, pathologic patterns and immunophenotypic features were analysed, with literatures reviewing. Results The size of the lump was 3 cm ×2 cm, and the border of it was infiltrative. The lump was composed of plump but regular spindle-shaped fibroblasts laking nuclear hyperchromasia and pleomorphism. A few of multinucleated osteoclastlike giant cells can be seen in the tumour. The spindle cells expressed vimentin, smooth muscle actin and muscle specific aetin. The giant cells expressed CD68 （ KP-1 ）. There was no cytokeratin positive cell in the lump. Conclusions Recurrence of nodular fasciitis after excision is rare. Metastasis does not occur. Because of the difficulty in the differential diagnosis between nodular fasciitis and some benign or malignant tumours, the use of immunohistochemical studies is essential in the evaluation of any spindle cell proliferations of the breast.