误诊为肉瘤的结节性筋膜炎之临床病理研究

A Clinical and Pathological Study on Nodular Fasciitis

目的 探讨结节性筋膜炎被误诊为肉瘤的原因。方法 观察 74例被误诊为肉瘤的结节性筋膜炎临床病理及免疫组化特点 ,其中对 6 2例采用 ABC、L SAB法行免疫组化染色。结果 74例病人临床表现均为良性经过 ,但镜下组织学极似肉瘤形态 ,6 8例获随访 ,结果均存活 ,复发率不足 1% ;6 2例做了免疫组织化学染色 ,梭形细胞 Vimentin阳性 ,MSA、SMA和KP1 部分病例阳性 ,Keratin、S- 10 0、Desimin均为阴性。结论 结节性筋膜炎本质是炎症而非肿瘤 ,注意临床资料 ,并结合镜下无巨大怪异细胞。

Objective To investigate the causes of overdiagnosis of nodular fasciitis Method 74 cases of nodular fasiitis which were overdiagnosed to sarcoma was analysis of clinical, pathological and immunohistochemical study Results All cases showed benign clinical condition, but histology suggests a tumour rather than an inflammation, easily wrongly suggest a sarcoma Follow-up information was avaible in 68 of 74 cases 2 cases recurrence, recurrence rate is less than 1% Immunohistochemical staining done 62 cases The spindle cells showed all to be positive in Vimentin, 37 cases positive in SMA, 21 in MSA and KP 1 but all were negative for Keratin、 S-100 Protein and Desimin Conclusion Nodular fasciitis is inflammatin Combined the distinctive clinical and pathological charater (especial no grossly bizarre cells and necrosis) is the key way prevent misdiagnosis to sarcoma