侵袭性纤维瘤病超声影像及病理学特征分析

Ultrasound image and pathological features analysis of invasive fibromatosis

目的探讨侵袭性纤维瘤病的超声影像及病理学特征,为侵袭性纤维瘤病的诊断提供依据。方法回顾性分析山西省肿瘤医院2016年1月至2019年3月22例经术后病理诊断为侵袭性纤维瘤病患者的临床病理资料,总结其临床、超声及病理学特征。结果侵袭性纤维瘤病超声影像表现为形态不规则、界限不清、回声不均、点灶状或条状血流信号等特征;超声诊断符合率59.1%(13/22),误诊为纤维、脂肪等来源肉瘤3例,神经来源肿瘤4例,结节性筋膜炎1例,胃肠间质瘤1例。侵袭性纤维瘤病病理学特征较为典型,免疫组织化学Vimentin及β-catenin阳性表达率均为100.0%(22/22);术前穿刺病理诊断符合率78.6%(11/14),误诊为神经纤维瘤1例,低度恶性纤维黏液样肉瘤1例,结节性筋膜炎1例。结论侵袭性纤维瘤病在超声及病理诊断上有一定特异性,根据超声影像和病理学特征可对其进行诊断和鉴别诊断。

Objective To investigate the ultrasound image and pathological features of invasive fibromatosis,and to provide a basis for the diagnosis of invasive fibromatosis.Methods The clinicopathological data of 22 patients pathologically diagnosed with invasive fibromatosis from January 2016 to March 2019 in Shanxi Provincial Cancer Hospital were retrospectively analyzed.The clinical,ultrasound and pathological data were also summarized.Results Ultrasound images of invasive fibromatosis showed irregular morphology,unclear boundaries,uneven echo,spot-like or strip-shaped blood flow signals.The coincidence rate of ultrasound diagnosis was 59.1%(13/22),3 cases were misdiagnosed as fibrous,fat and other sarcomas,4 cases were misdiagnosed as nerve-derived tumors,1 case was misdiagnosed as nodular fasciitis,and 1 case was misdiagnosed as gastrointestinal stromal tumor.The pathological characteristics of invasive fibromatosis were more typical,and the positive expression rate of vimentin andβ-catenin in immunohistochemistry was 100.0%(22/22);the coincidence rate of preoperative pathological diagnosis of puncture was 78.6%(11/14),1 case was misdiagnosed as nerve fiber tumor,1 case was misdiagnosed as low-grade fibromyxoid sarcoma,and 1 case was misdiagnosed as nodular fasciitis.Conclusion Invasive fibromatosis has a certain specificity in ultrasound and pathological diagnosis,which can be diagnosed and differentially diagnosed according to the ultrasound image and pathological characteristics.