卵巢核分裂象活跃的富于细胞性纤维瘤的临床病理学观察

Clinical Pathological Observation on Fibroma with Ovarian Mitotic Activity and Rich Cells

目的探讨卵巢核分裂象活跃的富于细胞性纤维瘤的临床病理学特征和诊断鉴别方法。方法对2012年3月榆林子洲县人民医院收治的1例卵巢核分裂象活跃的富于细胞性纤维瘤患者的病理学特征和免疫组织化学等资料进行分析。结果巨检镜检免疫组织化学检查显示灰白色的肿瘤物,大小为7.2 cm×5.0 cm×3.7 cm,表面较光滑;切面呈灰白色,部分出现灰黄色,质地稍韧,部分质柔软;未见出血及坏死。镜检显示致密增生梭形纤维母细胞样,周围边界不清晰,细胞核呈现卵圆形或者梭形,并且无轻度异型性。肿瘤的部分区域有红染瘢痕样纤维,水肿区瘤细胞呈现星芒型,并且细胞核呈现卵圆形或者短梭形。病理诊断显示为卵巢核分裂象活跃的富于细胞性纤维瘤,术后半年随访观察无复发与淋巴结转移。结论卵巢核分裂象活跃的富于细胞性纤维瘤形态上很容易与纤维肉瘤混合,且生物学行为显示为良性。临床中可以采取镜检和巨检以及免疫组织学方法进行诊断,提高该病的诊断效果。

Objective To investigate the clinical pathological features and differential diagnosis for fibmma with ovarian mitotic activity and rich ceils. Methods One ease of fibrous tumor featured with ovarian mitotic activity and rich eells from People＇s Hospital of Yulin Zizhou in March 2012 was studied, analyzing pathological features and immuuohistochemistry staining characteristics, Results Grossly tumor displayed gray matter, with a size of 7.2 cm × 5.0 cm × 3.7 cm, smooth surface ; gray cut surface, some appear sallow, slightly tough texture, some soft; no hemorrhage or necrosis. Microscopy displayed dense proliferation of fibro- blast-like spindle,perimeter not clear, oval or spindle-shaped nuclei, and no mild atypia. There were some areas of tumors stained red scar-like fibers, edema tumor ceils showed astral type, and showed ovoid nuclei or short spindle. Pathological diagnosis displayed fibroma with mitotic activity and rich cells,six months follow-up observation discovered no recurrence or lymph node metastasis. Conclusion Fibmma with ovarian mitotic activity and rich cells is easily mixed with fibrosarcoma in morphology, and the biological behavior appears benign. Macro examination and immunohistoehemical methods can be adopted for diagnosis in clinical to improve the diagnostic performance.