纤维母细胞性网状细胞肿瘤的临床病理学特征分析

Clinicopathological Features of Fibroblastic Reticular Cell Tumor

目的分析纤维母细胞性网状细胞肿瘤的临床病理学特征。方法对1例淋巴结纤维母细胞性网状细胞肿瘤的临床资料进行回顾性分析,同时结合相关文献进行复习。结果患者左侧颈部肿块间歇性增大3年。取左侧颈部淋巴结活检。光镜下淋巴结结构破坏,可见异型肌纤维母细胞样细胞呈条束状、席纹状排列,瘤细胞呈卵圆形、梭形,胞质粉染,边界不清,空泡状核,见1～3个小核仁,核分裂偶见(平均10/10HPF),可见病理性核分裂像。免疫组织化学结果:瘤细胞Vim、α-SMA、Desmin、CD68弥漫强阳性;Calponin、S100弱阳性,Ki-67阳性率约20%,余抗体LCA、CD20、CD3、AE1/AE3、EMA、CD30、CD15、CD1α、HMB45、MelanA、CD34、ALK、CD21和CD35阴性。结论纤维母细胞性网状细胞肿瘤极为罕见,其生物学行为很难判断。临床上需与滤泡及交指状树突细胞肿瘤等鉴别。

Objective To analyze the clinicopathological features of fibroblastic reticular cell tumor （FRCT）. Meth- odsClinical data of l FRCT of lymph node were analyzed retrospectively, and reviewed with the related literatures. Results A mass of the patient~ left neck enlarged intemlittently in 3 years. A lymph node of the left neck was selected by biopsy. Microscopi- cally, The structure of lymph node was destroyed. Myofibroblast-like cells could be seen, with definite atypia. Tumor cells were ar- ranged with bundles or storiform structure, and appeared oval or spindle in shape, with pink cytoplasm and indistinct borderline, nuclear vacuoles and 1 to 3 small nucleolus, mitotis could be seen easily （about 10/10HPF on the average） and pathologic mito- sis could be seen. Immunohistochemical results：Tumor cells displayed strong diffuse reactivity for Vim,α-SMA,Desmin, CD68, and weak positive for Calponin ,S-100, Ki-67 proliferation index showed positive about 20% , LCA ,CD20 ,CD3 ,AE1/AE3 ,EMA, CD30,CD15,CD1α,HMB45,MelanA ,CD34,ALK,CD21 and CD35 showed negative. Conclusion FRCT is rarely seen,and its biological behavior is hard to determine. It should be distinguished from FDC and IDC tumor et al.