皮下多发性侵袭性血管黏液瘤的病理形态学研究

Pathological study of subcutaneous multiple aggressive angiomyxoma

目的:探讨多发性侵袭性血管黏液瘤的临床病理特点。方法:对1例发生在男性皮下浅表部位的侵袭性血管黏液瘤进行形态学和免疫组化观察,并讨论软组织黏液性肿瘤的诊断和鉴别诊断。结果:本例肿瘤为多发,其中最大者位于阴囊。镜下肿物位于真皮浅层和皮下,大量黏液性基质中散在梭形和星芒状肿瘤细胞,深部侵犯周围皮下脂肪组织,部分区域角囊肿形成。结论:黏液性肿瘤的诊断需要结合发病年龄、部位等临床特点以及免疫组化染色来综合考虑。皮肤浅表血管黏液瘤和侵袭性血管黏液瘤可能属于同一疾病谱的不同阶段,本例形态学上兼有两者的特点,表现为侵袭性地生长,可能属于两者之间的中间型。

Objective： To investigate the clinic pathological features of subcutaneous multiple aggressive angiomyxoma. Methods：A case of subcutaneous multiple aggressive angiomyxoma in a 23-year-old man was studied with histopathologic observation and immunohistochemistry staining.Results：The case are multiple lesions and the largest lesion located in scrotum. Histologically, the lesions occur in the dermis and subcutis, consisting of an abundant hypocellular myxoid matrix containing bland spindle shaped and stellate cells. The tumour margins are poorly delineated with irregular infiltration of the adjacent fatty tissues. Conclusion：The diagnosis of myxoid tumors need consider many clinicpathological features such as age, gender and location. This case presents all of the histopathological features of superficial angiomyxoma and aggressive angiomyxoma, so we presume that the two tumors may be belong to the different stages of one disease spectrum and the case is an intermediate type.