腱鞘巨细胞瘤47例临床病理分析

Giant cell tumor of tendon sheath:A clinicopathological analysis of 47 cases

目的探讨腱鞘巨细胞瘤的临床病理特征,对其鉴别诊断进行探讨。方法收集47例腱鞘巨细胞瘤,根据临床病理学特点、形态学观察及免疫组化染色进行分析。结果 47例腱鞘巨细胞瘤患者中男15例(31.9%),女32例(68.1%),男女比为1:2.1,平均年龄43岁,≥31岁者35例(74.5%),发生于手部29例(61.7%)、足部18例(38.3%)。肿瘤细胞由数量不等的中等大小滑膜样多形性单核细胞、破骨样多核巨细胞、泡沫样吞噬细胞组成,伴有不同程度的胶原化,另见散在及灶性炎细胞浸润,部分组织细胞内有含铁血黄素颗粒存在。结论腱鞘巨细胞瘤是一种起源于腱鞘和关节滑膜层的良性病变,为较少见的纤维组织细胞肿瘤,免疫组化检查可作为诊断及鉴别诊断的重要参考依据。

Objective To study the clinicopathological features of Giant cell tumor of tendon Sheath and discuss its differential diagnosis. Methods The clinical and pathological characteristics of 47 cases of Giant cell tumor of tendon sheath were selected and paraffin-embedded sections histochemical staining and immunohistochemical staining. Results Male in 47 cases of tendon sheath giant cell tumor of 15 cases（31.9%）, female 32 cases （68.1%）, male to female ratio was 1：2.1. The patients average age at diagnosis were 43 years, ≥ 31 years of age in 35 cases（74.5%）, occur in the hand in ：29 cases （61.7%）, in the foot in 18 cases （38.3%）. Tumor cells by varying amounts of synovial samples of medium-size pleomorphic mononuclear cells, osteoclast-like muhinucleated giant cells, foamy phagocytic cells, and with varying degrees of collagen, the other can be seen scattered and focal inflammation cell infiltration , hemosiderin granules in some of the tissue cells. Conclusion Tenosynovial giant cell tumor that originated in the benign lesions of the tendon sheath and synovial layer, rare cell tumor of fibrous tissue, immunohistochemistry can be used as important reference for the diagnosis and differential diagnosis .