椎管内原发性孤立性纤维性肿瘤临床病理观察(附2例报告)

目的探讨椎管内孤立性纤维性肿瘤的临床病理特征、诊断和鉴别诊断,以期提高对该肿瘤的诊断水平。方法复习2例椎管内原发性孤立性纤维性肿瘤的临床资料,并观察其组织学特征和免疫组化标记。结果2例患者男、女各1例,年龄分别为23岁和32岁,临床表现为局部神经压迫症状。MRI示椎管内髓外硬膜内占位。组织学特征为梭形、卵圆形细胞呈束状、波浪状或旋涡状排列,富于胶原纤维及伴有分支状薄壁血管。细胞未见异型性和核分裂像。免疫组化示瘤细胞Vimentin( ),CD34( ),CD99( ),Bcl-2( ),AACT(-),Actin(-),S-100(-),EMA(-),GFAP(-),CD68(-),CD117(-),SMA(-),NF(-)。结论椎管内原发性孤立性纤维性肿瘤是一种罕见的肿瘤,诊断主要依靠病理形态学及免疫组化,并应与椎管内的其他梭形细胞肿瘤鉴别。

Solitary fibrous tumor in the spinal canal, report of two cases and review of the literature

Objective To explore the clinical pathological features,diagnosis and differential diagnosis of solitary fibrous tumors(SFT)in the spinal canal.Methods Two cases of SFT in the spinal canal was reviewed and the histological and immunohistochemical features was examined.Results One was male,and the other female,aged 23 and 32 respectively.The tumor caused clinical symptoms of spinal cord compression.MRI showed intradural extramedullary masses.The histological characteristics of the tumor were fascicular or wave-like arrangements.Neoplastic cells were spindle or oval with focally high celluarity.Plenty of blood vessels were identified in the stroma:partial hemangioma or hemangiopericytoma-like structure with palpable bunchy collagen.The atypical and mitoses was not found.Immunohistochemically,the tumor cells were positive for Vimentin,CD34,CD99,and Bcl-2,and negative for Actin,S-100,EMA,GFAP,AACT,CD68,CD117,SMA,and NF.Conclusion SFT in the spinal canal is a rare spindle-shaped neoplasm.Diagnosis is based on its morphology and immunohistochemistry.Differential diagnosis includes other spindle-shaped cell tumors in the spinal canal.