大阴唇富细胞性血管纤维瘤一例报道

Cellular angiofibroma of the labium majus: a case report

富细胞性血管纤维瘤(CAF)是一种少见的良性间叶性肿瘤。该文报道了1例右侧大阴唇CAF。患者女,39岁,因发现外阴肿物4月余就诊,无疼痛,无阴道异常流血、流液等不适。体格检查见右侧大阴唇一肿物,大小约5 cm×4 cm,质韧,表面光滑,边界清晰,无压痛。彩色多普勒超声提示外阴良性肿瘤,结缔组织来源可能。予外阴肿物切除术。切除的肿物呈结节状,大小为4.5 cm×4.2 cm,局部隆起,表面光滑,质韧。镜下见肿物由弥漫分布的短梭形细胞和卵圆形细胞构成,伴间质均匀分布的小血管。免疫组织化学染色示瘤细胞Ki-67约1%阳性、Desmin弱阳性、雌激素受体阳性、孕激素受体阳性,病理诊断为右侧大阴唇CAF。CAF的镜下病理特征是肿瘤由梭形细胞构成,伴胶原纤维束及大量均匀分布的小血管,部分肿瘤雌激素受体及孕激素受体阳性。手术切除为该病的主要治疗手段,患者预后良好。

Cellular angiofibroma( CAF) is a rare benign mesenchymal tumor. This article reported a case of CAF affecting the right labium majus. A 39-year-old woman was admitted due to a painless mass at the right labium majus for over 4 months with no abnormal vaginal bleeding or discharge. Physical examination detected a well-demarcated rubbery painless mass at the right labium majus with smooth surface,measured 5 cm× 4 cm in size. Color Doppler ultrasound hinted the benign tumor derived from connective tissues. The mass was then surgically excised. The nodular rubbery mass with regional bulge and smooth surface was 4. 5 cm ×4. 2 cm in size. Microscopically,the tumor was composed of diffuse spindle-shaped cells and oval-shaped cells,accompanied with evenly-distributed small vessels. Immunohistochemical staining revealed approximately 1% of the tumor cells were positive for Ki-67,weakly positive for Desmin,positive for estrogen receptor( ER)and progesterone receptor( PR). She was pathologically diagnosed with CAF. Under microscopic observations,the CAF was pathologically characterized with spindle-shaped cells accompanied with collagenous fiber and a large quantity of evenly-distributed small vessels. Partial tumor cells were positive for ER and PR. Surgical resection remains the primary treatment of CAF and yields relatively favorable clinical prognosis.