18例隆突性皮肤纤维肉瘤临床病理分析

Clinicopathologic Analysis on 18 Cases of Dermatofibrosarcoma Protuberans

目的:观察18例隆突性皮肤纤维肉瘤的临床及病理组织学特点,探讨诊断及鉴别诊断.方法:对18例隆突性皮肤纤维肉瘤进行回顾性分析.结果:复查18例隆突性皮肤纤维肉瘤的常规石蜡切片,并对部分病例进行重复切片,18例中有10例术后复发,其中4例2次复发,1例4次复发,无1例转移.组织学特点为梭形瘤细胞围绕小血管排列呈车辐状结构,且遍布整个瘤体;瘤细胞成分单一,核轻度异型,核分裂像少见;瘤细胞常向皮下脂肪呈树枝状浸润性生长.结论:隆突性皮肤纤维肉瘤发生于真皮,病程长,常反复复发,罕见转移.临床上第一次手术尽可能做局部广泛切除,可降低复发率.

Objective：To study the clinical and histopathologic features of 18 cases of dermatofibrosarcoma protuberans and discuss its diagnosis and differential diagnosis.Methods：Analyzing 18 cases of this disease retrospectively.Results：The paraffin sections of this disease were checked and some samples were sliced again.Among 18 cases,10 cases recurred,4 cases recurred two times and 1 case recurred four times.No metastasis happened to any case.Histologic features included that oncocyte was arranged radially surrounding small vessels and was found all over the sarcoma.Oncocyte component was unitary.Nuclear atypia appeared slightly and caryocinesia was less seen.Oncocyte grew infiltratively into subcutaneous fat in dendritic shape.Conclusion：This disease originates in dermis,The recurrence of this disease can be redaced probably and rare metastasis,and bears the features of long course,probable recurrence and rare metastasis.The recurrence of this disease can be reduced by widespread ablation in the first operation.