外耳道深部良性纤维组织细胞瘤侵犯颅内1例并文献复习

Unusual case of deep benign fibrous histiocytoma in external ear canal with intracranial invasion (one case report and literature review)

目的探讨深部良性纤维组织细胞瘤的病理、临床表现、影像学特点及鉴别诊断。方法报道1例外耳道深部良性纤维组织细胞瘤的临床资料,并对相关文献进行复习。结果本例患者病史8年,肿块局部侵犯乳突、翼内外肌、颅内等,但无远处转移。镜检可见梭形的成纤维细胞成漩涡状排列及其间多核巨细胞、炎性细胞浸润,免疫组化检查示:CD68(+),Vim(+),S-1 0 0(+),CD 1 a(-),Ki-6 7(-)。上述特点符合深部良性纤维组织细胞瘤诊断。结论深部良性纤维组织细胞瘤是一种临床少见、诊断复杂、预后好的良性肿瘤,手术完整切除能明显降低其复发率。

Objective To explore the pathology,clinical and image features and the differential diagnosis of deep benign fibrous histiocytoma.Methods Clinical data of a patient suffering from benign fibrous histiocytoma loated in the deep part of the external ear canal was analyzed retrospectively with literature review.Results The patient owned 8-year history and neoplasma locally invasived into mastoid process,pterygoid muscle and intracalvarium,but without distant metastasis.Mcroscopic examination showed spindle fibroblasts arranged into a whirlpool with multinucleated giant cells and inflammatory cell infiltration.Immunohistochemical examination showed CD68（＋）,Vim（＋）,S-100（＋）,CD1a（-）,Ki-67（-）.Therefore the diagnosis of deep benign fibrohistiocytoma was confirmed.Conclusion Deep benign fibrous histiocytoma is a rare benign tumor with good prognosis,but the diagnosis is usually challenging.Complete surgical resection can significantly reduce the recurrence rate of this tumor.