5例肌纤维母细胞瘤病理分析

目的：探讨肌纤维母细胞瘤的临床病理及免疫组化特征。方法：对5例肌纤维母细胞瘤进行组织病理学，免疫组化研究，结合文献资料分析本病临床表现，病理形态及鉴别诊断。结果：组织学由具有平滑肌细胞和纤维母细胞特征的梭形肿瘤细胞，大量慢性炎细胞及黏液血管样背景构成。免疫组化myosin（＋）、desmin（＋）、Vimentin（＋）。结论：肌纤维母细胞瘤是既具有平滑肌细胞特征，又具有纤维母细胞特征的独立性肿瘤。     

肌纤维母细胞瘤的病理分析（附3例报告）

目的探讨肌纤维母细胞的临床病理及免疫组化特征方法对3例肌纤维母细胞进行组织病理学，免疫组化研究，结合文献资料分析本病临束表现病理形态及鉴别诊断结果组织学由具有平滑肌细胞和纤维母细胞特征的梭形肿瘤细胞，大量慢性炎细胞及粘液血管样背景构成免疫组化SMActinc( )、desmin( )、Vimentin( )。电镜下可见肌纤维母细胞特征结论肌纤维母细胞瘤是既具有平滑肌细胞特征，又具有纤维母细胞特征的独立性肿瘤。     

阴道血管肌纤维母细胞瘤1例及文献复习

目的探讨阴道血管肌纤维母细胞瘤的临床病理学特征及鉴别诊断。方法对1例阴道血管肌纤维母细胞瘤进行临床病理形态学及免疫组化分析,并复习文献20余篇。结果阴道血管肌纤维母细胞瘤临床无特异性,镜下见薄壁血管丰富、大小不等,呈簇状分布;瘤细胞和核多样化,肌纤维母细胞分布不均,多细胞密集区和少细胞疏松区交替出现。免疫组化结果显示Vi2mentin阳性2P2,Desmin阳性2P4,SMA阳性3P4,CD34阳性4P4,CD31阳性1P2,S2100全部阴性。结论阴道血管肌纤维母细胞瘤是罕见的软组织肿瘤,具有独特的光镜及免疫组化特点,可与其他软组织肿瘤鉴别。     

膀胱炎症性肌纤维母细胞瘤1例报告

目的：探讨膀胱炎症性肌纤维母细胞瘤（IMT）的临床特点及治疗。方法：回顾性分析1例膀胱炎症性肌纤维母细胞瘤的临床资料。结果：患者因间歇性肉眼血尿2月,伴尿急尿频、下腹胀痛不适4天入院;B超、CT和MRI发现膀胱右侧壁巨大肿块突入膀胱腔,手术切除包块,病理学检查报告为膀胱炎症性肌纤维母细胞瘤;术后3月复查膀胱超声和膀胱镜检未见复发。结论：病史、B超、CT和MRI是诊断膀胱炎症性肌纤维母细胞瘤的重要手段,确诊依靠病理学检查。     

膀胱炎性肌纤维母细胞瘤1例报告并文献复习

目的:探讨膀胱炎性肌纤维母细胞瘤(IMT)的临床特点及治疗。方法:回顾性分析1例膀胱炎性肌纤维母细胞瘤的临床资料。结果:患者因无痛性全程肉眼血尿10d入院,膀胱镜检查发现膀胱前壁肿块突入膀胱腔,手术切除包块,病理学检查报告为膀胱炎性肌纤维母细胞瘤;术后3个月复查膀胱超声和膀胱镜未见复发。结论:膀胱炎性肌纤维母细胞瘤为罕见疾病,易误诊、误治。病史、B超、CT和MRI、膀胱镜检查等是诊断膀胱炎性肌纤维母细胞瘤的重要手段,确诊依靠病理学检查。     

输尿管炎性肌纤维母细胞瘤临床病理观察

目的：探讨输尿管炎性肌纤维母细胞瘤（IMT）的临床病理特征。方法：报道1例输尿管炎性肌纤维母细胞瘤。结果：B超示左输尿管实性包块;免疫组化：SMA（＋）S-100（＋）Vim（＋）。术后随访1年未见复发。结论：输尿管炎性肌纤维母细胞瘤罕见,临床可表现为腹部包块,腹痛,确诊需病理检查及免疫组化。     

3例血管肌纤维母细胞瘤病理报道及文献复习

目的研究血管肌纤维母细胞瘤的病理特征和免疫组织化学表型以及它的鉴别诊断。方法通过对3例血管肌纤维母细胞瘤的临床表现、病理特征和鉴别诊断以及免疫组化的研究,结合文献复习,总结血管肌纤维母细胞瘤的临床病理和免疫组化特征及鉴别诊断。结果血管肌纤维母细胞瘤均境界清楚,肿瘤由相互交错分布的细胞密集区和细胞稀疏区组成,其间血管丰富,多为毛细血管至中等大薄壁血管;瘤细胞成巢或束状围绕血管周围排列,可见红细胞漏出。免疫表型：肿瘤细胞V im entin、ER和PR阳性,desm in大都数阳性、少数阴性,CD34、CK和S-100蛋白均阴性。结论血管肌纤维母细胞瘤全身多处部位可见,发病部位以女性外阴及盆腔最多见;其生物学行为及组织来源尚无定论,需与侵袭性血管粘液瘤、富于细胞性血管纤维瘤等相鉴别。     

膀胱炎性肌纤维母细胞瘤的研究进展

膀胱炎性肌纤维母细胞瘤是一种少见的交界性膀胱软组织真性肿瘤,临床表现及术前影像学检查常提示膀胱恶性肿瘤,易误诊而导致膀胱全切,常需根据术后病理检查及免疫组织化学检查进行确诊。目前主要治疗方式为膀胱部分切除或经尿道膀胱肿瘤电切术,且术后不需要常规膀胱灌注化疗,大部分预后良好,少数可复发、转移。近年来对膀胱炎性肌纤维母细胞瘤的报道及研究逐渐增多,本文将从膀胱炎性肌纤维母细胞瘤的临床表现、影像学、病理特征以及发病机制及预后等方面进行综述。     

鼻窦炎性肌纤维母细胞瘤诊治与预后

目的 探讨鼻窦炎性肌纤维母细胞瘤的临床特征及诊断与治疗方法.方法 对1例上颌窦炎性肌纤维母细胞瘤的临床特征进行分析,并总结其诊断与治疗方法.结果 鼻窦炎性肌纤维母细胞在CT上没有特征性表现,但CT能为本病的诊断提供诸如肿块的内部结构特征、肿块所累及的范围等情况.病理示瘤组织由梭形纤维细胞及大量炎性细胞组成.免疫组化染色肌源性蛋白呈阳性表达.结论 上颌窦的炎性肌纤维母细胞瘤是非常罕见的,诊断主要依靠病理及免疫组织化学检测,可采用外科手术为主的包括激素治疗和化疗的综合治疗措施.     

炎性肌纤维母细胞瘤临床病理分析

目的报道1例儿童输尿管炎性肌纤维母细胞瘤(IMT),结合文献资料,分析其临床病理特征、诊断与鉴别诊断。方法采用常规制片、HE染色、辅以免疫组化染色。结果肿瘤组织由梭形细胞构成,成束状或编织状排列,免疫组化SMA(+)、Vimentin(+),病理诊断:炎性肌纤维母细胞瘤。结论炎性肌纤维母细胞瘤是一种比较少见的软组织肿瘤,诊断主要依据病理诊断和免疫组化,鉴别诊断有横纹肌肉瘤、纤维瘤病、低度恶性的成纤维肉瘤、结节性筋膜炎、平滑肌肉瘤。     

An unusual presentation of aggressive fibromatosis (retroperitoneal desmoid tumour) in pelvic cavity presented as obstructed labour

Retroperitoneal desmoid tumours are uncommon tumours usually occurring in young females in their reproductive age group and commonly have a benign course but sometimes they can become malignant. These tumours belong to family of myofibroblastic fibromatosis. These tumours are composed of fibroblastic cells with bands of collagen and ill defined cytoplasm and rarely show mitosis. Recurrence is common especially after incomplete excision. Retroperitoneal desmoid is an uncommon tumour among desmoid group which led to an obstructed labour. Here a 28-year-old female diagnosed to have a pelvic desmoid, was missed during the antenatal check-up, presented as an obstructed labour which necessitated a caesarean section. The patient underwent a definitive surgery three months later for excision of tumour. The tumour was excised through a combined abdominal and gluteal incision. Histopathological report revealed an aggressive fibromatosis (retroperitoneal desmoid).     

Successful treatment and follow-up of a case of recurrent pseudosarcomatous myofibroblastic proliferation

This report describes a case of recurrent pseudosarcomatous myofibroblastic proliferation (PMP) of the bladder with a satisfactory clinical course after a 3.5-year follow-up. There is a lack of reports of successful treatment experiences on recurrent PMP of the bladder in adults. For the primary lesion, a transurethral resection of the bladder tumor (TUR-BT) was performed; for the recurrent lesion, a combination regime of TUR-BT and intravesical mitomycin C proved effective treatment. The patient did not suffer local recurrence or distal metastasis during the 3.5-year follow-up. Our experience may serve as treatment reference to urologists who encounter similar cases.Inflammatory myofibroblastic tumor (IMT) and pseudosarcomatous myofibroblastic proliferation (PMP) of the bladder are rare entities that were first described by Roth in 1980.1 Recently, it is not clear if PMP is a “true tumor” or “benign proliferative mesenchymal lesion.” Although an overwhelming majority of reported PMP cases have been benign in nature, some researchers still consider that close surveillance is necessary owing to its histological similarity to some malignant tumors.2-5 Rosai6 found a non-random chromosomal translocation in chromosome 2p23, supporting the theory that PMPs are true neoplasms. In this study, we illustrated a locally recurrent PMP to support its clonal origin in a patient who underwent treatment with transurethral resection of the bladder tumor (TUR-BT) and chemotherapy with mitomycin C and presented a satisfactory clinical course during a 3.5-year follow-up.     

膀胱炎性肌纤维母细胞瘤的影像表现及临床分析

目的:探讨膀胱炎性肌纤维母细胞瘤(inflammatory myofibroblastic tumor,IMT)的临床表现、影像特征、病理特点及治疗方法,提高对本病的认识。方法:对南京医科大学附属无锡市人民医院手术病理证实的5例膀胱IMT患者的CT、MR表现及临床资料进行系统性分析,并结合文献进行总结。结果:临床表现为血尿、尿痛等症状;CT平扫呈均匀或不均匀肿块,MRI平扫T1WI为等低信号,T2WI为略高信号,增强扫描延迟期肿块实质部分呈持续性明显强化;镜下所见梭形细胞增生,编织状或者排列紊乱,伴有混合性炎细胞浸润,背景可呈黏液样;免疫组化Vim、SMA、MSA多阳性,Actin、HHF-35、Des部分阳性,Kertin、E-mA、S-100均为阴性;5例均通过手术切除。结论:膀胱IMT临床症状与恶性肿瘤相似,影像学表现有一定特征性,确诊主要依靠病理及免疫组化,治疗方法以膀胱部分切除或经尿道切除为主。     

膀胱炎性肌纤维母细胞瘤4例报道及文献复习

目的:复习文献并探讨膀胱炎性肌纤维母细胞瘤(inflammatory myofibroblastic tumor,IMT)的临床表现、病理特点、诊断及治疗方法。方法:回顾分析4例膀胱IMT患者的资料,并结合文献进行分析。结果:4例术前均行B超及膀胱镜检查并活检,3例病理诊断为膀胱炎性病变可能,膀胱肿瘤不能排除;1例报告为膀胱IMT。4例均行膀胱部分切除,术后病理确诊为膀胱IMT。3例随访至今未见复发,1例随访7个月后失访。结论:膀胱IMT临床特征酷似膀胱肿瘤,确诊主要依靠病理学检查,手术是治疗本病的主要方法。     

Effect of small interfering RNA targeting survivin gene on biological behaviour of bladder cancer

Background Bladder cancer is the most common type of urinary system tumours. It is frequently associated with genetic mutations that deregulate the cell cycle and render these tumours resistant to apoptosis. Survivin, a newly discovered member inhibitor of apoptosis protein （IAP） family in several human cancers, by inducing cell proliferation and inhibiting apoptosis is frequently activated in bladder cancer. We studied the influence of small interfering RNA （siRNA） targeting survivin on the biological behaviour of bladder cancer cells. Methods A double strand survivin target sequence specific siRNA was designed and synthesized. After transfection of bladder cancer cell line T24 by siRNA/liposome complex with increasing concentrations （50-200 nmol/L）, the transfectant cells were intratumourally injected at different doses （5 μg or 50 μg）. The effects were measured in vitro and in vivo. Results The selected siRNA efficiently down-regulated survivin mRNA expression in a dose and time dependent manner. The maximal effect was achieved at the concentration of 100 nmol/L, at which survivin expression level was down-regulated by 75.91%. The inhibition rate of cell growth was 55.29% （P〈0.01） and the markedly increased apoptotic rate was 45.70% （P〈0.01）. In vivo intratumoural injection of 50 μg siRNA-survivin could notably orevent the growth of bladder cancer （P〈0.01） in xenografted animals. Conclusion The application of siRNA-survivin could markedly inhibit survivin expression in bladder cancer cell line by inducing apoptosis and inhibiting the growth of the tumour. It may become a new gene therapy tool for bladder cancer.     

低度恶性肌纤维母细胞性肉瘤

目的 探讨低度恶性肌纤维母细胞性肉瘤的临床病理学特征、免疫学表型及鉴别诊断.方法 对1例发生于后腹膜的低度恶性肌纤维母细胞性肉瘤进行光镜观察、免疫组化标记并结合文献进行复习.结果 肿瘤细胞呈梭形,排列成束,显示中度异型性,可见核分裂像(3～4个/10HPF).免疫表型:瘤细胞弥漫性广泛表达Vim、SMA,不表达MSA、Des、和S100蛋白.结论 低度恶性肌纤维母细胞性肉瘤是一种少见的软组织肉瘤,组织学形态及免疫表型显示瘤细胞具肌纤维母细胞性分化.应与纤维瘤病、纤维肉瘤和平滑肌肉瘤相鉴别.     

黑色素瘤形态学和免疫表型的变化

在黑色素瘤中能观察到多种细胞形态学特征、组织构型和基质的变化。黑色素瘤可以由大的多形性细胞或小细胞或梭形细胞组成，也可含有透明细胞、印戒细胞、假脂母细胞、横纹样细胞、浆细胞样细胞和气球细胞，在细胞质中存在各种各样的包涵体或吞噬物。细胞核可呈双核或多核或分叶核，可有核内包涵体，形成核沟或成角。组织构型的变化包括束状、漩涡状、巢状、小梁状、假腺样／假乳头状／假滤泡状、假玫瑰花样或中央脉管样。基质呈黏液样变或促纤维增生改变，极少呈假血管肉瘤改变、肉芽肿性炎症或伴破骨巨细胞反应。基质的血管可呈血管周细胞瘤样，血管球样血管增殖或血管周透明变性。黑色素瘤特异性标记物是S-100蛋白、NKIC3、HMB45、Melan A和酪胺酸酶，但一些黑色素瘤可能出现异常的免疫表型。     

Inflammatory myofibroblastic tumour of the duodenum

Inflammatory myofibroblastic tumours (IMTs) of the duodenum and head of the pancreas are rare. They are of probable immunological aetiology and preoperatively indistinguishable from adenocarcinomas of the pancreatic head. We describe a patient with duodenal IMT and gastric outlet obstruction, and present a review of pancreatic head and duodenal IMTs in the literature. IMTs of the pancreatic head present as obstructive jaundice, while those of the duodenum present as gastric outlet obstruction. Surgery is the primary modality of treatment. Adjuvant chemotherapy and radiotherapy are controversial and reserved for incomplete resections and IMTs of a pathologically aggressive nature. Otherwise, recurrence is uncommon and surgery curative.     

Ameloblastic fibrosarcoma: an immunohistochemical and ultrastructural study of the mesenchymal component]

To study the characteristics of the mesenchymal cells of ameloblastic fibrosarcoma (AFS), three cases of AFS were studied immunohistochemically and ultrastructurally. The results showed that the mesenchymal component of AFS consisted predominantly of fibroblastic cells with a small number of undifferentiated cells, a few histiocytes and occasionally myofibroblastic cells under electron microscope. The fibroblastic cells were Vimentin positive only, and myofibroblastic cells were positive for Vimentin, HHF35 and alpha-SMA. The histiocytes were positive both for kp1 and PG-M1, suggesting that these cells were infiltrating cells from peripheral blood rather than histiocytic differentiation of tumor cells. Compared with ameloblastic fibroma, AFS showed much higher PCNA labeling index, suggesting higher proliferation activity of AFS.