黏液炎症性纤维母细胞肉瘤2例临床病理观察

Myxoinflammatory fibroblastic sarcoma:a clinicopathologic analysis

目的探讨黏液炎症性纤维母细胞肉瘤的临床病理特征、免疫表型、诊断及鉴别诊断。方法通过HE和免疫组化染色对2例黏液炎症性纤维母细胞肉瘤的临床病理学特征进行分析并文献复习。结果 2例黏液炎症性纤维母细胞肉瘤,分别发生于左前臂及左肘部。组织学上表现为界限不清的浸润性生长的结节样肿物,呈现显著的黏液背景,伴大量炎细胞浸润。散在分布于炎细胞中的肿瘤细胞为纤维母细胞样细胞,部分为梭形或上皮样,部分为大多角形或奇异形,核仁明显;可见类似于霍奇金淋巴瘤中的RS细胞的双核细胞。免疫组化显示vimentin(+),部分细胞CD68(+);CD3、CD20、CD30、CD31、CD34和SMA均(-)。结论本瘤为较罕见的具有局部侵袭性的交界性肿瘤,应与一些良性及恶性的软组织肿瘤及肿瘤样病变相鉴别。

Objective To study the clinicopathologic features of myxoinflammatory fibroblastic sarcoma. Methods HE and immunohistochemistry were used to investigate the clinical, radiological, histological and immunophenotype features of myxoinflammatory fibroblastic sarcoma. The literatures were reviewed. Results Two cases of myxoinflammatory fibroblastic sarcoma were located in the left forearm and left elbow,respectively. Two cases included one female（68 years old） and one male（81 years old）. Histologically,the tumor was multinodular and poorly delineated. The spindle or epithelioid fibroblastic cells scattered in the inflammatory and myxoid background. Some cells showed the ReedSternberg like appearance. Immunohistochemical study showed that vimentin and CD68 were positive. CD3,CD20,CD30,CD31,CD34 and SMA were negative. Conclusions The myxoinflammatory fibroblastic sarcoma is a rare and locally aggressive tumor. The diagnosis should be combined with the histological characteristics and immunohistochemical results.It should be differentiated from the other tumors and tumor-like lesions.