血管球瘤11例临床病理观察

Glomus tumors： a clinicopathological observation of 11 cases

目的探讨血管球瘤（GT）的临床病理学特征和鉴别诊断。方法对11例GT的临床特征、组织学形态和免疫学表型进行观察。结果7例肿瘤发生于手指甲下，2例发生于前臂皮下，1例发生于膝关节皮下，1例发生于胃窦后壁。临床主要表现为局部疼痛。9例诊断为实体性球瘤，2例诊断为球血管瘤，其组织学特点为肿瘤细胞小、圆形、大小一致，呈巢状、小簇状围绕于毛细血管、扩张的小静脉周嗣，间质玻璃样变性及黏液变性。免疫组织化学：11例肿瘤细胞SMA、Vimentin均为（＋）；而CK、CD228、CD34、CgA、Syn、Desmin、S-100、HMB45均为（-）。11例患者术后随访12～30个月，均无复发或转移。结论GT非常少见，确诊依赖组织学和免疫组织化学检测。该肿瘤发生于内脏时极易误诊，需要和其他肿瘤鉴别。

Objective To investigate the clinicopathological features of glomus tumor and its differential diagnosis. Methods Clinical, morphologic and immunohistochemical representations were described in 11 cases of glomus tumor. Results The tumors were located at tbe hyponycbial in 7 cases, forearm subcutaneous in 2 cases, knee subcutaneous in 1 case, gastric antrum forewall in 1 eases. Localized pain was the primary symptom. 9 glomus tumors were histopathologically classified as solid type, and 2 glomangiomatous type. The prominent morphologic features of glomus tumor were as follows： the tumor cells were small, round, uniform, the tumor cells arranged around capillary vessel or expansion of the small vein showing nest pattern, some tumor cells in fasciation pattern; focally myxoid change in the stroma were seen. Immunohistochemistry： 11 cases were positive for SMA and Vimentin; while other markers including CK, CD117, CD34, CgA, Syn, Desmin, S-100 and HMB45, were all negative. All 11 cases were without any evidence of recurrence or metastasis in followed-up for 12-30 months. Conclusion Glomus tumor is extremely rare. The diagnosis depends on the histology and immunohistochemistry. Glomus tumor is rare in visceral sites. It may be misdiagnosed and needs to he differentiated from other tumors.