增生性筋膜炎9例临床病理分析

Proliferative fasciitis:A clinicopathological analysis of 9 cases

目的:探讨增生性筋膜炎(PF)临床病理特点及鉴别诊断,提高对增生性筋膜炎的认识,避免误诊。方法:回顾性分析9例增生性筋膜炎的临床情况、组织学形态及免疫表型并复习相关文献。结果:PF好发于四肢及头颈部,发病年龄为32~80岁。临床表现为伴有疼痛,迅速生长浅表孤立性肿块。镜下特点为黏液样背景、增生的纤维母细胞/肌纤维母细胞、间质散在分布具有诊断意义的神经节样大细胞;免疫组化梭形细胞及神经节样大细胞表达Vimentin、SMA和H-Caldesmon。结论:PF是一种较少见的良性病变,手术切除后罕见复发,不转移,其特殊的临床表现及病理形态特征,易被误诊为恶性肿瘤。应加强对该病变的认识,避免误诊。

Objective： To discuss the clinicopathologic features and differential diagnosis of proliferative fasciitis（ PF） and to improve the understanding of PF and avoid misdiagnosis. Methods： The histological,immunological phenotype and clinical features in 9 cases of PF were studied and the previous literatures were reviewed. Results： PF develops more frequently in the limbs,head and neck. The age of patients is 32 ~ 80 years old. The main clinical symptom is rapidly enlarged isolated nodular with or without tenderness and the histological features include myxoid stroma,proliferating fibroblasts / myofibroblast,scattered lymphocytes,erythrocytes and the ganglion-like cells with diagnostic significance. Immunophenotyping,Vimentin,SMA and H-Caldesmon were positive staining in the spindle cells and ganglion-like cells. Conclusion： PF was a benign lesion with rare recurrence after surgical resection. Because of its clinical and pathological features,the PF easily is misdiagnosed as malignant tumor. Therefore,we need to improve our understanding and diagnostic capabilities on PF so that to avoid misdiagnosis.