血管肌纤维母细胞瘤的临床病理和鉴别诊断

目的　探讨血管肌纤维母细胞瘤 (AMF)的临床病理特征和鉴别诊断。方法　通过 4例AMF的病理形态和免疫组化研究 ,结合复习文献总结AMF的临床病理特征和鉴别诊断。结果　肿瘤境界清楚 ,直径 <5cm ,瘤细胞梭形或卵圆形 ,常围绕血管排列 ,呈疏密交替分布特征。免疫表型 :desmin、SMA、vimentin、CD34、ER和PR阳性或部分阳性 ,而MSA、S 10 0蛋白、Mac387和CK均阴性。结论　AMF是一种主要发生于生育期女性外阴的良性软组织肿瘤 ,需与侵袭性血管黏液瘤、富细胞性血管纤维瘤等相鉴别     

血管肌纤维母细胞瘤16例临床病理分析

目的探讨血管肌纤维母细胞瘤（angiomyofibroblastoma,AMF）的临床病理、免疫组化特征、组织来源以及鉴别诊断。方法通过16例AMF的临床表现、病理形态和免疫组化研究,并结合文献复习,总结AMF的临床病理、免疫组化特征及鉴别诊断。结果16例AMF,大体境界清楚,无包膜,可见一层假纤维膜包绕;组织学上呈疏松水肿样,丰富薄壁海绵样血管,肿瘤细胞多样性,梭形及上皮样细胞多见,常围绕血管排列呈疏密交替分布特征。免疫组化结果：瘤细胞desmin及vimentin呈弥漫强阳性表达,actin、CD34、ER和PR染色稍弱、呈灶状分布,而S-100蛋白、NF和CK均阴性。结论AMF临床上多无明显症状;发病部位以女性外阴及盆腔最多见,但全身多处部位也可见;其生物学行为及组织来源尚无定论;术前很难确定诊断AMF,需与侵袭性血管黏液瘤、富于细胞性血管纤维瘤等相鉴别。     

血管肌纤维母细胞瘤3例并文献复习

目的 探讨血管肌纤维母细胞瘤(angiomyfibroblastoma,AMF)的临床病理特征、诊断和鉴别诊断.方法 对3例AMF进行组织学观察和免疫组化标记,抗体为vimentin、SMA、MSA、ER、PR、CD34、desmin、S-100蛋白和CK.结果 3例均表现为外阴部肿块.眼观:肿瘤境界均清楚;镜检:肿瘤均由相互交替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.瘤细胞呈巢状或束状围绕血管排列.免疫表型:瘤细胞vimentin、SMA、ER和PR均阳性,CD34在血管壁呈阳性、瘤细胞阴性,MSA、desmin、S-100蛋白和CK均阴性.结论 AMF是一种少见的好发于外阴的良性软组织肿瘤,需与侵袭性血管黏液瘤、富细胞性血管纤维瘤等鉴别.     

女性下生殖道的浅表性肌纤维母细胞瘤

女性外阴阴道处的软组织肿瘤可分为解剖部位相对特异性的病变和那些可发生于身体任何部位的病变，包括外阴阴道。前者包括以前认识清楚的一类肿瘤如血管肌纤维母细胞瘤(AMF)、侵袭性血管黏液瘤(AA)和富于细胞性血管纤维瘤(CA)。最近Laskin等描述了一种具有比较特异性的临床病理和免疫组化表型的良性间叶性肿瘤，并将其命名为宫颈阴道肌纤维母细胞瘤(SCVM)。     

血管肌纤维母细胞瘤2例报道及文献复习

目的 探讨血管肌纤维母细胞瘤(AMF)的临床病理特征及诊断和鉴别诊断。方法 对2例AMF进行组织学观察和免疫组化S—P法标记，抗体为vimentin、desmin、SMA、S—100蛋白、CD34、ER、PR、CK等。结果 1例为30岁女性，表现为外阴囊肿；1例为51岁男性，表现为腹股沟区精索肿块。眼观：肿瘤境界均清楚；镜检：肿瘤均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。其中1例尚可见成群分布的脂肪细胞存在。免疫表型：瘤细胞vimentin(2／2)、ER(2／2)、PR(2／2)、SMA(1／2)、CD34(2／2)阳性，SMA(1／2)、S—100蛋白(1／2)灶性阳性，desmin、CK阴性。结论 AMF是一种少见的好发于外阴生殖道的间质肿瘤，可能来源于血管周具有多向分化潜能的干细胞，可向肌纤维母细胞分化。在组织形态上AMF应与侵袭性血管黏液瘤、富细胞性血管纤维瘤、浅表性血管黏液瘤、纤维上皮性间质息肉、梭形细胞脂肪瘤相鉴别。     

血管肌纤维母细胞瘤2例临床病理分析

目的探讨血管肌纤维母细胞瘤(angiomyofibroblastoma,AMF)的临床病理学特征、免疫表型、诊断及鉴别诊断。方法对2例AMF的临床病理资料及免疫组化SP法染色结果进行分析,并复习相关文献。结果 2例均为女性外阴肿瘤,边界清,切面灰白色,有暗红色斑点或针尖大暗红色腔隙,实性,质韧。镜下肿瘤由交替分布的细胞密集区和细胞稀疏水肿区构成,其间有大量丰富的毛细血管和中等大小的薄壁血管;瘤细胞形态温和,呈梭形或卵圆形,常呈束状围绕血管排列。免疫表型:2例瘤细胞vimentin均强阳性,desmin、SMA局灶阳性;ER和PR在例1中强阳性,在例2中弱阳性;CD163在例2中大部分瘤细胞阳性,在例1中少数瘤细胞阳性;S-100、CD34、D2-40、CK均阴性,Ki-67增殖指数均小于3%。结论 AMF是一种好发于女性外阴的良性间叶细胞肿瘤,根据组织学特征和免疫表型可进行诊断,需与发生在外阴的其它软组织肿瘤进行鉴别;完整切除肿瘤是AMF的主要治疗方法。     

血管肌纤维母细胞瘤临床病理特征

目的：探讨血管肌纤维母细胞瘤的临床病理形态特征及鉴别诊断。方法：对2例血管肌纤维母细胞进行组织病理学、免疫组织化学研究,结合文献资料分析本病的临床表现、病理形态特点及鉴别诊断。结果：血管肌纤维母细胞瘤呈大片黏液背景、丰富薄壁海绵样血管和梭形上皮样细胞即肌纤维母细胞,后者胞质丰富,呈嗜酸性,核卵圆或杆状,两端对称变细或稍钝,瘤细胞分布有明显的疏密区,密集区聚于血管周围,成束或链状排列、疏松区弥散于黏液背景中,且瘤细胞常与胶原纤维伴行。结论：血管肌纤维母细胞瘤为良性肿瘤,好发于女性外生殖器,起源与肌纤维母细胞相关,既向纤维,又向平滑肌分化,且伴有丰富的海绵样薄壁血压和间质黏液变性。     

儿童肢体软组织及骨的肌纤维瘤/肌纤维瘤病28例临床病理学分析

目的探讨儿童肢体软组织及骨的肌纤维瘤/肌纤维瘤病的临床病理学特征、诊断及鉴别诊断。方法收集2011年1月至2018年12月就诊于北京积水潭医院的28例儿童肢体软组织及骨的肌纤维瘤/肌纤维瘤病临床及影像学资料, 行光镜观察和EnVision两步法免疫组织化学染色, 并复习相关文献。结果 28例肌纤维瘤/肌纤维瘤病患儿年龄2个月至14岁, 平均7岁。女患儿7例, 男患儿21例。12例发生于肢体软组织:手部9例, 上臂1例, 足部2例。单骨病变14例:股骨8例, 胫骨2例, 锁骨2例, 腓骨1例, 桡骨1例。累及多骨的肌纤维瘤病2例。骨内病变影像学显示溶骨性改变。组织学上瘤细胞呈梭形、卵圆形, 肌纤维母细胞样, 呈显著的细胞密集区与稀疏区交替双相分布, 间质黏液样, 并见血管周排列。发生骨内可见刺激新骨形成, 并伴有炎性肌纤维母细胞瘤及血管瘤样形态。免疫组织化学显示波形蛋白、平滑肌肌动蛋白阳性。经随访, 1例在术后11个月复发。结论儿童肌纤维瘤/肌纤维瘤病骨内病变预后较好, 具有独特的形态学特征, 结合免疫组织化学可与其他梭形细胞肿瘤进行鉴别。     

外阴富于血管和（或）黏液的软组织肿瘤病理诊断

外阴有不少软组织肿瘤富于血管和 (或 )有丰富的黏液 ,它们之间容易混淆 ,免疫组化也很难提供有鉴别意义的信息。近年对这些肿瘤有了更深入认识 ,作者主要就血管肌纤维母细胞瘤、细胞性血管纤维瘤、浅表性血管黏液瘤和侵袭性血管黏液瘤等肿瘤的诊断和鉴别诊断的有关问题进行讨论。1　纤维上皮间质性息肉 (ｆｉｂｒｏｅｐｉｔｈｅｌｉａｌｓｔｒｏｍａｌｐｏｌｙｐ ,ＦＳＰ)　　又可称为纤维上皮性息肉 (ｆｉｂｒｏｅｐｉｔｈｅｌｉａｌｐｏｌｙｐ)、软纤维瘤 (ｓｏｆｔｆｉｂｒｏｍａ)、软垂疣 (ａｃｒｏｃｈｏｒｄｏｎ)或皮垂。临床表现 :…     

侵袭性血管黏液瘤7例临床病理分析

目的探讨侵袭性血管黏液瘤(aggressive anginomyxoma,AAM)的临床病理特征与鉴别诊断。方法收集7例AAM,并与2例血管肌纤维母细胞瘤(AMFb)、1例浅表性血管黏液瘤作对照观察。免疫组织化学(采用SP法)所用抗体为vimentin、desmin、SMA、MSA、CD34、ER/PR、S-100蛋白、CK和CD68。结果7例AAM患者均为女性,23~54岁,中位年龄43·5岁。病变部位位于外阴部3例,累及阴道1例,位于盆腔及髂窝部2例,会阴累及坐骨结节1例。肿瘤直径3·5~17cm,平均7·5cm。位于皮下或较深部,呈浸润性生长,切面均质灰白或灰黄褐色,黏液胶冻样或肉质样。镜下瘤细胞幼稚,呈星形、梭形,弥漫或结节样分布,基质黏液样变性并见胶原纤维及为数众多的大小厚薄不一的血管分布其中,厚壁血管常透明变性,其周围常有增生肌纤维束,切面呈“袖套状”,间质可见肥大细胞和红细胞外渗,1例可见多核巨细胞,肿瘤边缘浸润等特点。组织化学奥辛蓝染色阳性,免疫组化:7例AAM vimentin均阳性,5例SMA和desmin阳性,4例MSA阳性,3例CD34阳性,4例中有3例ER/PR阳性,而S-100蛋白、CK、CD68均阴性,多核巨细胞CD68阳性。5例有随访,术后1~2年有3例复发,2例未见复发和转移,健在。结论侵袭性血管黏液瘤较为少见,好发于成年女性盆腔及会阴的软组织,侵袭性和复发性是其重要的临床特征。病理诊断易误诊或漏诊。免疫组化desmin、SMA、MSA、CD34等联合检测对确定AAM病变有所帮助,但与AMFb、浅表性血管黏液瘤在鉴别诊断上意义不大。     

儿童特殊类型肾母细胞瘤5例临床病理学分析

目的：探讨儿童特殊类型肾母细胞瘤的临床病理学特点、诊断要点及鉴别诊断。方法：收集5例儿童特殊类型肾母细胞瘤病例进行临床资料、病理形态学及免疫组织化学分析,并结合文献探讨其诊断与鉴别诊断。结果：5例患儿中男童3例,女童2例,年龄4月~2岁,中位年龄1岁,主因腹部包块、无痛性肉眼血尿或腹胀、发热就诊,左肾(3例)多于右肾(2例)。其中部分囊状分化型3例,镜下见肿瘤由大小不一的囊腔构成,内衬扁平、立方或鞋钉样上皮细胞,间隔见间叶、胚芽或上皮的肾母细胞瘤成分;肾母细胞瘤伴肾源性残余2例,镜下见由间叶、胚芽和上皮等构成的典型肾母细胞瘤成分,周围见胚芽和上皮细胞与正常肾组织混合存在。结论：部分囊状分化的肾母细胞瘤(cystic partially differentiated nephroblastoma,CPDN)、肾母细胞瘤伴肾源性残余是少见特殊类型的肾母细胞瘤,术前临床诊断及鉴别诊断困难,只有依靠术后病理作出准确诊断,为患儿治疗及预后提供可靠依据。     

Autocrine motility factor/glucose-6-phosphate isomerase is a possible predictor of metastasis in bone and soft tissue tumours

In order to assess the involvement of autocrine motility factor (AMF) in mesenchymal tumours, AMF protein and mRNA expression was analysed in tumours, tumour-like lesions, and other lesions of bone and soft tissue. Immunohistochemical analysis of 200 cases revealed positive staining in 72.5% of the cases, suggesting that AMF is a widely expressed protein. Chordoid, chondroid, and muscular tumours revealed higher immunoreactivity in both benign and malignant tumours. Immunoblotting analysis corroborated the results of immunohistochemistry. Generally, malignant tumours revealed higher expression of AMF than benign tumours of the same histopathological lineage, except for dermatofibroma/dermatofibrosarcoma protuberans. However, mRNA levels were not concordant with protein levels, and sarcomas that displayed higher mRNA and lower protein expression levels showed a trend for distant metastasis. In cultured cells, AMF was secreted and detected in conditioned culture medium. Furthermore, when proteasome inhibitors were added to cells in order to examine the changes in turnover rates, these compounds did not significantly alter the intracellular levels of AMF protein. On the basis of these overall findings, it is suggested that a particular subset of sarcomas secrete AMF, rather than degrading this protein at a higher turnover rate. This secreted AMF presumably enhances their cell motility through an autocrine effect and eventually causes increased metastatic potential. Collectively, AMF was observed in a wide spectrum of lesions of mesenchymal tissue, supporting the notion that it is involved in various cellular functions, including proliferation, differentiation, metabolism, and metastasis. In addition, higher expression of its mRNA may indicate higher levels of protein secretion and define a particularly aggressive group of tumours with high metastatic potential.     

Expression of autocrine motility factor mRNA is a poor prognostic factor in high-grade astrocytoma

It has been reported that tumor infiltration is correlated with the expression of autocrine motility factor (AMF) and its receptor 78 kDa glycoprotein (gp78). The purpose of the present study was to detect AMF and gp78 mRNA expression levels and their localization in high-grade astrocytomas (glioblastoma and anaplastic astrocytoma) and to determine whether AMF and gp78 are important prognostic factors. A total of 32 formalin-fixed and paraffin-embedded glioblastomas and 23 formalin-fixed and paraffin-embedded anaplastic astrocytomas was used. The expressions of AMF and gp78 mRNA were detected using the highly sensitive in situ hybridization method. The expression of AMF mRNA was detected in 27 of 32 glioblastomas (84.4%) and 11 of 23 anaplastic astrocytomas (47.8%). The positivity of AMF mRNA was significantly higher in glioblastomas than in anaplastic astrocytomas (P = 0.0094), but gp78 mRNA was detected in most cases and no statistical significance was observed. The overall survival of patients with AMF expression was significantly shorter than patients without AMF expression (P = 0.0175). In anaplastic astrocytomas, the overall survival of patients with AMF expression was also significantly shorter than in patients without AMF expression (P = 0.0058). This study demonstrated that AMF is a poor prognostic factor in high-grade astrocytomas.     

肿瘤侵犯相关蛋白自分泌运动因子在瘢痕疙瘩中的表达*

背景：肿瘤侵犯相关蛋白自分泌运动因子在肿瘤细胞中表达量增高,并可增强肿瘤细胞的生长、侵犯和转移能力,而瘢痕疙瘩具有恶性肿瘤生物学特性。 目的：了解肿瘤侵犯相关蛋白自分泌运动因子在人体瘢痕疙瘩、增生性瘢痕、生理性瘢痕组织中的表达情况。 方法：生理性瘢痕、增生性瘢痕、瘢痕疙瘩患者各20例,切取3种瘢痕组织;用组织免疫荧光染色法观测3种瘢痕组织中自分泌运动因子的分布及相对表达量;用蛋白质免疫印迹法和荧光定量PCR检测3种瘢痕组织中的自分泌运动因子蛋白水平和基因水平的表达。 结果与结论：在组织水平、蛋白水平、基因水平上,生理性瘢痕和增生性瘢痕组织中自分泌运动因子的表达较低,且二者分布及相对表达量差异无显著性意义,而瘢痕疙瘩组织中,自分泌运动因子在3个水平上的表达强度明显增高,与前二者比较差异有显著性意义(P < 0.01)。结果提示自分泌运动因子与瘢痕疙瘩的肿瘤生物学特征有着密切的关系。关键词：肿瘤侵犯相关蛋白;瘢痕疙瘩;自分泌运动因子;蛋白质免疫印迹法;荧光定量PCR doi:10.3969/j.issn.1673-8225.2012.20.012     

Prevalence of Accessory Mental Foramina: A Study of 4,000 CBCT Scans

The presence of accessory mental foramina (AMF) is an important consideration prior to any dental implant and surgical treatment to avoid injury to the neurovascular bundle and subsequent postoperative complications. The aim of this retrospective study was to determine the prevalence of AMF from a substantially large sample of the Australian population. The cone beam computed tomography (CBCT) scans of 4,000 patients showing the mandible were examined. All mental foramen (MF) were visualized and no cases were excluded. The number of MF/AMF, sex, and age were recorded. The prevalence of AMF was found to be 6.4% (254 patients) in this study. Twelve patients exhibited bilateral AMF, and 11 had three mental foramina on one side. One case had a total of five mental foramina with three on the right and two on the left side. No significant sex preference was discovered. This is the largest study ever to be conducted to evaluate the prevalence of AMF. With nearly one in 15 individuals found to have AMF, clinicians must be acutely aware of this anatomical variation and treatment plan for each case accordingly. Clin. Anat. 32:1048–1052, 2019. © 2019 Wiley Periodicals, Inc.     

Anatomical study of the accessory mental foramen and the distribution of its nerve.

We examined the range of the accessory mental foramen [AMF] and its accessory mental nerve in three Japanese cadavers. The diameters of the AMF were relatively small: 0.74 mm, 0.80 mm and 0.89 mm. The distances between the mental foramen and AMF were: 0.67 mm, 2.1 mm and 5.74 mm. The distribution of the accessory mental nerve was different in the three cases. These nerves communicated with the branches of the facial and buccal nerves.     

Accessory mental foramina associated with neurovascular bundle in Korean population

Purpose

To determine the prevalence and anatomical features of accessory mental foramina (AMFs) associated with neurovascular bundle using reformatted CBCT images in Korean population.

Materials and methods

Three-dimensional, cross-sectional, and axial images of CBCT from total 446 patients were evaluated. To include only AMF associated with neurovascular bundle, the course of accessory nerve through AMF was evaluated on three-dimensional images. The prevalence, locations to mental foramen (MF), and distribution to the adjacent tooth of AMF were analyzed. Additionally, the distance from MF and dimension of AMF were measured.

Results

AMFs were found in 36 (8.1 %) patients in the 446 Koreans. The prevalence rate of AMFs in male was significant higher than that in female (p < 0.05). Most AMFs were located anterior–superior to MF. The shortest distance between the center of AMF and that of MF was 5.80 mm (SD ± 2.90, 1.40–13.0). Variance of location of AMF in relation to MF was greater in the horizontal direction than in the vertical direction. In related to adjacent tooth, AMF was mainly distributed between the first and second premolars. The horizontal dimension and vertical dimension of AMF were 1.54 mm (SD ± 1.41, 0.70–9.80) and 1.44 mm (SD ± 0.41, 0.70–2.30), respectively.

Conclusions

Knowledge of AMF is important for performing effective nerve block and avoiding injuries to neurovascular bundles passing through AMF. Evaluation of the course of AMF in three-dimensional image of CBCT is effective for confirming AMF associated with inferior alveolar nerve.