动脉瘤样纤维组织细胞瘤4例临床病理观察(1)
摘要：目的 探讨动脉瘤样纤维组织细胞瘤的病理学特点、免疫表型、诊断及鉴别诊断。方法 对4例动脉瘤样纤维组织细胞瘤的石蜡标本行HE及免疫组织化学染色，回顾性分析患者临床资料，随访并复习相关文献，分析其临床表现及病理学特征。结果4例患者中，男2例，女2例，3例位于四肢，1例位于腹部。镜下肿瘤均具有典型皮肤纤维瘤的组织学特征，不规则出血性裂隙、囊腔结构，伴有含铁血黄素沉积。免疫组化显示波形蛋白和CD68阳性，血管标记物均阴性。结论 AFH形态学上有出血性裂隙、囊腔，需与血管肉瘤和血管瘤样纤维组织细胞瘤等恶性肿瘤进行鉴别。
关键词：纤维组织细胞瘤;纤维瘤;病理特征
中图分类号：R139.5 文献标识码：B DOI：10.3969/j.issn.1006-1959.2019.01.055
, 百拇医药
文章编号：1006-1959(2019)01-0173-02
Clinicopathological Observation of 4 Cases of Aneurysmal Fibroblastoma
ZHANG Ru-yi
(Department of Pathology，the Second Affiliated Hospital，Zhejiang University School of Medicine，Hangzhou 310009，Zhejiang，China)
Abstract：Objective To investigate the pathological features， immunophenotype， diagnosis and differential diagnosis of aneurysmal fibroblastoma. Methods HE and immunohistochemical staining were performed on 4 paraffin-embedded specimens of aneurysmal fibroblastoma. The clinical data of the patients were retrospectively analyzed. The related literatures were followed up and analyzed. The clinical manifestations and pathological features were analyzed. Results Of the 4 patients， 2 were male and 2 were female， 3 were in the extremities and 1 was in the abdomen. Microscopically， the tumors have the histological features of typical cutaneous fibroids， irregular hemorrhagic fissures， cystic structures， and hemosiderin deposition. Immunohistochemistry showed vimentin and CD68 positive， and vascular markers were negative. Conclusion There is hemorrhagic fissure and cyst in the morphology of AFH. It needs to be differentiated from malignant tumors such as angiosarcoma and angiotumoid fibroblastoma.
, 百拇医药
Key words：Fibrous histiocytoma;Fibroids;Pathological features
動脉瘤样纤维组织细胞瘤(aneurysmal fibrous histiocytoma，AFH)属于皮肤纤维瘤的病理学变异型，首次由Santa Cruz和Kyriakos M于1981提出，仅占2%的纤维组织细胞瘤，多发生于中年，好发于肢体[1]。该肿瘤极为少见，较普通组织细胞瘤的复发率高，约为19%，组织学上极易误诊为血管性肿瘤或黑素细胞性肿瘤[2]。现将4例患者报道如下，并对该肿瘤的组织病理学特征进行分析。
1资料及方法
1.1一般资料 收集嘉兴市第二医院2011年1月～2016年12月明确诊断的AFH患者4例，其中，男性2例，女性2例，中位年龄41岁(33～52岁)。3例位于下肢，1例位于腹壁。病变皮损为红色至暗褐色结节，质中等硬度，直径0.8～1.5 cm。3例患者近1个月皮损快速增大。2例患者压痛，4例均无外伤史及蚊虫叮咬史。临床拟诊为皮肤纤维瘤1例、血管瘤3例。
1.2试剂 免疫组织化学染色所用一抗包括CD34、CD31、Desmin、CD68、Vimentin、HMB45，均为即用型抗体，购自北京中杉金桥公司。, 百拇医药(张如意)
关键词：纤维组织细胞瘤;纤维瘤;病理特征
中图分类号：R139.5 文献标识码：B DOI：10.3969/j.issn.1006-1959.2019.01.055
, 百拇医药
文章编号：1006-1959(2019)01-0173-02
Clinicopathological Observation of 4 Cases of Aneurysmal Fibroblastoma
ZHANG Ru-yi
(Department of Pathology，the Second Affiliated Hospital，Zhejiang University School of Medicine，Hangzhou 310009，Zhejiang，China)
Abstract：Objective To investigate the pathological features， immunophenotype， diagnosis and differential diagnosis of aneurysmal fibroblastoma. Methods HE and immunohistochemical staining were performed on 4 paraffin-embedded specimens of aneurysmal fibroblastoma. The clinical data of the patients were retrospectively analyzed. The related literatures were followed up and analyzed. The clinical manifestations and pathological features were analyzed. Results Of the 4 patients， 2 were male and 2 were female， 3 were in the extremities and 1 was in the abdomen. Microscopically， the tumors have the histological features of typical cutaneous fibroids， irregular hemorrhagic fissures， cystic structures， and hemosiderin deposition. Immunohistochemistry showed vimentin and CD68 positive， and vascular markers were negative. Conclusion There is hemorrhagic fissure and cyst in the morphology of AFH. It needs to be differentiated from malignant tumors such as angiosarcoma and angiotumoid fibroblastoma.
, 百拇医药
Key words：Fibrous histiocytoma;Fibroids;Pathological features
動脉瘤样纤维组织细胞瘤(aneurysmal fibrous histiocytoma，AFH)属于皮肤纤维瘤的病理学变异型，首次由Santa Cruz和Kyriakos M于1981提出，仅占2%的纤维组织细胞瘤，多发生于中年，好发于肢体[1]。该肿瘤极为少见，较普通组织细胞瘤的复发率高，约为19%，组织学上极易误诊为血管性肿瘤或黑素细胞性肿瘤[2]。现将4例患者报道如下，并对该肿瘤的组织病理学特征进行分析。
1资料及方法
1.1一般资料 收集嘉兴市第二医院2011年1月～2016年12月明确诊断的AFH患者4例，其中，男性2例，女性2例，中位年龄41岁(33～52岁)。3例位于下肢，1例位于腹壁。病变皮损为红色至暗褐色结节，质中等硬度，直径0.8～1.5 cm。3例患者近1个月皮损快速增大。2例患者压痛，4例均无外伤史及蚊虫叮咬史。临床拟诊为皮肤纤维瘤1例、血管瘤3例。
1.2试剂 免疫组织化学染色所用一抗包括CD34、CD31、Desmin、CD68、Vimentin、HMB45，均为即用型抗体，购自北京中杉金桥公司。, 百拇医药(张如意)