10例孤立性纤维性肿瘤的临床病理特征分析

Clinical and pathological features of 10 cases of solitary fibrous tumor

目的分析10例孤立性纤维性肿瘤（SFT）的临床病理特征、免疫组化表型和影像学特点，并与几种临床常见的梭形细胞肿瘤相比较，提高对SFT的诊断及鉴别诊断的认识。方法收集10例SFT的临床资料和影像学资料；苏木精-伊红染色切片观察病理形态学特点；免疫组化检测Vim、CD99、CD34、BcI-2、SMA、Des、S100、CD117、EMA在SFT、神经鞘瘤、神经纤维瘤、血管外皮细胞瘤、纤维组织细胞瘤、滑膜肉瘤、纤维肉瘤、胃肠道问质瘤的表达情况。结果10例SFT的临床表现多为无症状或相关部位的压迫症状。影像学表现多为相关部位的占位性病变。苏木精-伊红染色下观察所有肿瘤的基本病理形态学特征为梭形细胞肿瘤。免疫组化显示Vim、CD99、CD34、Bcl-2在10例SFT中的阳性表达例数分别为10／10、10／10、9／10、8／10，SMA和S100少数病例阳性，Des只有1例为灶性阳性，CDll7,EMA为阴性；其他肿瘤的阳性高表达指标各不相同。结论SFT的诊断和鉴别诊断主要依靠临床病理形态特点和免疫组化标记，联合使用Vim、CD99、CD34及Bcl-2可提高诊断准确率。

Objective To analyze the clinical and pathological features, imaging characteristics and immunohisto- chemical phenotype of 10 cases of solitary fibrous tumor （SFT） and compare with several common clinical spindle cell tumors, so as to improve the understanding of the diagnosis and differential diagnosis of SFT. Methods The clinical and imaging data of 10 eases of SFT were collected. Pathological changes were observed with hematoxylin and eosin staining; Immunohistochemical markers, including Vim, CD99, CD34, Bc1-2, SMA, Des, S100, CDl17, EMA were detected in SEF, schwannoma, neurofibroma, hemangiopericytoma, fibrous histioeytoma, synovial sarcoma, fibrosarcoma and gas- trointestinal stromal tumor by SP immunohistoehemical staining method. Results Clinical manifestations of 10 cases of SFT were mostly asymptomatic or oppression symptoms of relevant parts. Imaging findings showed the occupying lesions of relevant parts. All tumors in the microscopic images were spindle cell tumors. In 10 cases of SFT with immunohistochem- ical stainin positive cases of Vim, CD99, CD34 and Bcl -2 were 10/10, 10/10, 9/10 and 8/10, respectively; while CD117 and EMA were all negative, SMA and SIO0 were positive only in a few cases, only one case was focally positive of Des. High positive expression of other tumors were different. Conclusions The diagnosis and differential diagnosis of SFT mainly rely on pathological changes and immunohistochemical markers. The combined detection of Vim, CD99, CD34 and Bcl- 2 can improve the diagnostic accuracy.