腹腔内炎性肌纤维母细胞瘤5例分析并文献复习

Intra-abdominal inflammatory myofibroblastoma: analysis of 5 cases and literature review

目的 探讨腹腔内炎症性肌纤维母细胞瘤（IMT）的临床特点、病理学特征、治疗方案及预后因素.方法 对我院2008年6月至2013年5月诊治的5例腹腔炎症性肌纤维母细胞瘤患者的临床特点、病理形态、免疫组化及治疗方案进行分析并随访.结果 男性2例,女性3例,年龄31～74岁,平均年龄53.4岁.主要症状为腹部包块.5例均行手术切除后病理检查确诊.随访时间6月～5年,其中1例局部复发.肿瘤3例来源于大网膜,2例来源于肠系膜.免疫组化Actin、Vimentin、SMA多呈阳性,S-100、CD117、CD34呈阴性.结论 炎症性肌纤维母细胞瘤发病机制尚不明确,症状往往随着病变的切除而消失,手术切除是主要治疗方法.但其又具有一定的恶性倾向,部分患者术后复发,所以需要密切随访.

Objective To investigate the clinical features, pathological features, treatment options and prognosis of intra-abdominal inflammatory myofibroblastic tumor （IMT）. Methods Five cases of intra-ahdominal inflammatoly myofibroblastic tumor from our hospital during June 2008 to May 2013 were analyzed and followed-up with the clinical features ,pathological morphology, immunohisto- chemistry and treatment programs. Results The patients were included in 2 males and, 3 females, aged from 31 to 74 years old, and the mean age was 53.4 years old. The main symptoms are abdominal mass. All cases underwent surgical resection and the diagnosis was confirmed by pathological examination. The follow-up ranged from 6 months to 5 years, including one case of local recurrence. 3 cases of tumors derived from omentum, and 2 from mesentery. Immunohistochenfistry showed that Actin, Vimcntin and SMA were positive, while S-100, CD117 and, CD34 were negative. Conclusion The pathogenesis of IMT is not clear. The symptoms tend to disappear after surgical resection. Surgical resection is the primary approach in treatment of IMT. Considering the biological feature of the intermediate type of neoplasm in IMT, it needs to be followed-up closely.