指(趾)纤维骨性假瘤临床病理分析

Clinicopathological features of fibro-osseous pseudotumor of the digits

目的探讨指(趾)纤维骨性假瘤(fibroosseous pseudotumor,FP)的临床病理特点、诊断、鉴别诊断及生物学特征。方法收集9例指(趾)FP资料,进行组织病理学和免疫表型观察。结果9例FP男女比为7∶2,平均年龄为24.8岁,部位分别为指2例、掌2例、趾3例和足跟2例。临床上以局部肿胀或肿块伴疼痛为主。镜检:病变主要由增生的梭形细胞及散在的不规则骨组织构成且伴间质胶原化。梭形细胞形态较温和,偶见核分裂象。其中2例梭形细胞丰富,细胞肥胖,轻度异型性,核较大,卵圆形或梭形,见较多核分裂象。免疫表型:梭形细胞及骨母细胞表达vimentin,Ki-67<1%+,α-SMA、actin、S-100、desmin、CK和EMA均阴性。9例FP患者术后随访,一般情况良好,未见复发。结论指(趾)FP是一种罕见的、好发于指(趾)的良性增生性病变。熟悉FP的临床病理学特征对避免将其误诊为恶性肿瘤具有重要的意义。

Purpose To investigate the elinicopathological characteristic, diagnosis, differential diagnosis and biological behavior of fibroosseous pseudotumor （FP）. Methods The clinicopathologieal and immunophenotypie feautures were reviewed in 9 eases of FP. Results There were 7 men and 2 women with an average age of 24. 8 years. The FP grew rapidly on fingers （2 eases）, toes （3 eases）, heels （2 eases） and metacarpal bones （2 eases）, respectively. Microscopically, the lesion was composed of proliferative spindle cells with eollagenization and irregular osteoid tissue. In two cases, the plump spindle cells showed mild degree of atypia with enlarged nuclei and easily encountered mitotic figures. Immunohistochemically, the spindle cells were positive for vimentin, weakly positive for Ki67, but negative for α-SMA, muscle specific actin, S-100, desmin, CK and EMA. All the patients were well during the followingup after operation. Conclusion FP is a rare benign lesion on fingers or toes. The diagnosis can be made based on clinical data and histopathology of the tumor.