成人型纤维肉瘤1例

A Case of Adult Fibrosarcoma

患者男,78岁。左胫前皮下肿块2个月。皮肤科情况:左胫前可见一直径约3. 5cm的球形皮下肿物,肤色,界清,表面光滑,质轫,活动度差,无压痛。皮损组织病理示:不典型梭形细胞在真皮层弥漫分布,瘤细胞核仁明显,见病理性核分裂像,未排列成典型的"鱼骨"状。免疫组织化学示:波形蛋白(3+),Ki-67约15%(+),CD34和结蛋白(-)。诊断:成人型纤维肉瘤。予手术完全切除皮损,随访1年,未见复发。

A 78-year-old male presented with subcutaneous tumor on left lower limb for two months. Dermatology examinatoin showed subcutaneous tumor on the left lower limb with skin color and smooth surface. Histopathologic examinaton demonstrated atypical spindle-shaped cells diffuse distributing in dermis. A mass of cellularity with atypical nuclei, higher mitotic rate and less distinct ' herringbone ' pattern. The immunohistochemical examination of Vimentin and Ki67 were positive and CD34 as well as desmin were negative. Coupled with clinical and histopathological features,the diagnosis of fibrosarcoma was made. Surgical excison was made without recurrence during the a year long follow-up.