孤立性纤维性肿瘤35例临床病理研究

Solitary fibrous tumor:a clinicopathologic study of 35 cases

目的观察孤立性纤维性肿瘤（SFT）的临床病理及免疫表型特点，探讨其诊断、鉴别诊断及预后。方法对35例SFT进行光镜及免疫组化检测，并结合临床及病理特点进行分析。结果35例SFT的发病年龄为9-79岁，平均47．5岁，男女之比为1.2：1，发生于13个部位。镜下可见多种改变并存的现象：肿瘤由梭形细胞构成的细胞稀少区和富于细胞区交替分布，有粗大的瘢痕样玻璃变性的胶原、分支状的血管外皮瘤样结构及大量增生的呈血管瘤样改变的薄壁血管；偶见黏液变、小囊性变及脂肪细胞分化。其中9例为恶性SFT。结论孤立性纤维性肿瘤大部分为良性，肿瘤的病理形态与生物学行为之间不是绝对相关的（形态学为良性的SFP也可以有浸润），因此必须进行长期随访。一般情况下肿瘤有蒂和可以完整手术切除是良好的预后因素。

Objective To observe the clinicopathological and immunophenotype characteristics of solitary fibrous tumor, and to explore the diagnosis, differential diagnosis and prognosis of solitary fibrous tumor （SKF）. Methods The clinical and pathological characteristics were studied by hematoxylin and eosin stain and techniques in 35 cases of SFT Results The age of the patients with SFT ranged from 9 to 79 years. The ratio of male to female was 1.2： 1. SFT occurred in thirteen sites. Histologically, the tumors were characterized by a variety of growth patterns, including the spindle cells composed of hypo and hypercellular areas, keloid-like collagen bundles in the stroma, thin-walled branching vessels showing an HPC-like growth pattern, and prominent vascularity with numerous small and mid-sized vessels, occasionally with the area of myxoid, cystic and fatty degeneration. Conclusion The SKT mostly is a benign tumor, but a few could be malignant. The pathologic appearance of SKT cannot always predicts clinical behaviors （morphologically, some benign SKT may be invasive）. Therefore it is very important to follow-up all of SKF. Usually, patients with a pedunculated tumor and its complete excision has a good prognosis.