树突状纤维黏液脂肪瘤1例并文献复习

A case of dendritic fibromyxolipoma and literature review

目的:探讨树突状纤维黏液脂肪瘤(dendritic fibromyxolipoma,DFML)的形态学特点及鉴别诊断。方法:收集1 例DFML,观察其形态学特点、免疫表型及与相关肿瘤的鉴别诊断,并复习相关文献。结果:肿瘤由增生的短梭形或星形细胞组成,其间混杂有成熟的脂肪细胞,间质富于黏液,并有透明变性。免疫组化Vimentin、CD34、CD99、Bcl-2 均阳性;S-100、SMA、STAT-6、Desmin、CD21、CK和EMA均阴性;Ki67 阳性指数<1%。结论:DFML为良性肿瘤,需要与梭形细胞脂肪瘤(spindle cell lipoma,SCL)、孤立性纤维性肿瘤(solitary fibrous tumor,SFT)、黏液样脂肪肉瘤(myxoid liposarcoma,MLS)及低级别纤维黏液样肉瘤(low grade fibromyxoid sarcoma,LGFS)等相鉴别。

Objective: To explore the morphological features and differential diagnosis of dendritic fibromyxolipoma (DFML). Method: A case of DFML was collected to observe its morphological characteristics, immunophenotype and differential diagnosis with related tumors,and relevant literature was reviewed. Results:The neoplasm was composed of proliferating spindle or astrocyte cells intermixed with mature adipocytes and interstitium rich in mucus with hyaline degeneration. Immunohistochemical results of Vimentin, CD34, CD99 and Bcl-2 were positive. S-100, SMA, STAT-6, Desmin, CD21, CK and EMA were all negative. Ki67 positive index was less than 1%. Conclusion:DFML is a benign tumor,and should be differentiated from the spindle cells lipoma (SCL),solitary fibrous tumor(SFT),myxoid liposarcoma (MLS) and the low grade fibromyxoid sarcoma(LGFS) etc.