外阴血管肌纤维母细胞瘤1例并文献复习

目的：分析外阴血管肌纤维母细胞瘤（Angiomyofibroblastoma，AMFB）的临床病理特征。方法：结合文献复习，对1例罕见的AFMB进行临床特点、病理形态及免疫组化研究，并探讨其鉴别诊断。结果：AMFB在肉眼上表现为境界清楚的结节；显微镜下，该瘤呈现为在富于水肿和富于薄壁血管的背景中见细胞密集区和细胞稀疏区交替存在，瘤细胞梭形、胖梭形或上皮样，围绕血管排列，间质中见散在肥大细胞和淋巴细胞浸润。免疫组化瘤细胞表达Vimentin、CD34、CD99、bcl-2和PR，不表达Desmin、S-100、ER、EMA、AE1／AE3以及SMA。结论：AMFB是一种罕见的良性肿瘤，手术切除后未见局部复发，罕见恶变，可经外科完全切除而治愈。主要应与外阴侵袭性血管粘液瘤鉴别。     

外阴血管肌纤维母细胞瘤1例

患者，女，４２岁。１年前发现会阴下１／３后壁处一约１．０cm×１．０cm×０．６cm卵圆形肿物，无自觉症状，近１个月肿物明显增大。于２００１年１１月５日在本院行手术切除，大小约３．０cm×３．０cm，包膜完整，无蒂，切面浅棕色，质软。镜下观察肿瘤由梭形细胞和上皮样细胞构成，有明显的细胞密集区和疏松区；密集区瘤细胞呈束状、巢状排列，且围绕在许多小至中等大小薄壁血管周围，细胞界限不清，胞浆嗜酸性，核仁不明显，核分裂相未见。疏松区间质粘液水肿细胞少，细胞肥胖或梭形。纤细的胶原纤维分布在水肿的粘液间质中。免疫组化…     

外阴血管肌纤维母细胞瘤1例并文献复习

目的:分析外阴血管肌纤维母细胞瘤(Angiomyofibroblastoma,AM阳)的临床病理特征.方法:结合文献复习,对1例罕见的AFMB进行临床特点、病理形态及免疫组化研究,并探讨其鉴别诊断.结果:AMFB在肉眼上表现为境界清楚的结节;显微镜下,该瘤呈现为在富于水肿和富于薄壁血管的背景中见细胞密集区和细胞稀疏区交替存在,瘤细胞梭形、胖梭形或上皮样,围绕血管排列,间质中见散在肥大细胞和淋巴细胞浸润.免疫组化瘤细胞表达Vimentin、CD34、CD99、bcl-2和PR,不表达Desmin、S-100、ER、EMA、AE1/AE3以及SMA.结论:AMFB是一种罕见的良性肿瘤,手术切除后未见局部复发,罕见恶变,可经外科完全切除而治愈.主要应与外阴侵袭性血管粘液瘤鉴别.     

外阴血管肌纤维母细胞瘤临床分析

目的：分析外阴血管肌纤维母细胞瘤的临床及病理特征、治疗及预后。方法收集7例外阴血管肌纤维母细胞瘤,总结其临床表现、病理特征、治疗及预后,并结合国内外相关文献分析其发病机制及临床特征。结果7例患者临床症状主要为逐渐增大的无痛性外阴肿物,病理大体标本境界清楚,组织学上呈密集血管区与少细胞的水肿区交替分布。手术治疗为主,预后良好。结论外阴血管肌纤维母细胞瘤罕见,术前易误诊,超声可辅助诊断,治疗首选手术,术后需长期随访。     

外阴血管肌纤维母细胞瘤1 例

患者,女性,36岁,以"外阴肿物3年"为主诉于2009年5月27日入院.查体:左侧大阴唇见一大小约8cm×5cm肿物,囊性感,皮色正常,无压痛,与周围组织界限尚清.B超示:左大阴唇皮下低回声肿物,边界清,内回声均匀,肿块血供丰富.术中见肿块实质性,包膜完整,完整切除肿块至正常组织.术后未行辅助治疗,随访肿块无复发.     

外阴血管肌纤维母细胞瘤八例

目的探讨少见的血管肌纤维母细胞瘤（AMF）的临床病理特征和鉴别诊断。方法收集8例AMF,结合免疫组织化学和文献复习综合分析。结果8例AMF均为女性,平均年龄40．8岁。肿瘤境界清楚。平均最大直径3．0cm。瘤细胞呈梭形、星形,上皮样。常围绕血管疏密交替分布。间质疏松水肿,富含薄壁海绵状血管,见肥大细胞和红细胞外渗。免疫组织化学：瘤细胞vimentin和desmin弥漫阳性,actin、CD34、SMA、ER、PR不同程度表达。S-100和CK阴性。结论AMF是良性的软组织肿瘤,较少见,好发于女性阴部。临床常无明显症状。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五例临床病理观察

 目的 观察5例血管肌纤维母细胞瘤的病理形态和免疫组织化学表达情况，探讨其临床病理特征和鉴别诊断。方法 对5例血管肌纤维母细胞瘤进行常规病理检查和免疫组织化学技术，镜下观察。结果 肿瘤境界清楚，直径小于5 cm，瘤细胞呈梭形或较肥胖呈上皮样，形成围绕血管的富于细胞区及细胞稀少区。免疫组织化学示Vimentin，desmin，ER，PR，SMA阳性或部分阳性。结论 血管肌纤维母细胞瘤是一种好发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，浅表性血管黏液瘤等相鉴别。     

血管肌纤维母细胞瘤4例报道并文献复习

血管肌纤维母细胞瘤 (angiomyofi-broblastoma,AMF)是由 Fletcher[1 ] 在1992年首先报道的 ,是一种少见的生殖道良性软组织肿瘤 ,至 1999年国外报道近 90例 [1～ 8] 。国内报道甚少 [6 ,7] 。笔者在工作中遇到 4例现结合有关文献进行复习。1　病理临床资料本组 4例均为女性 ,年龄为 37岁、32岁、4 5岁、4 0岁 ,肿瘤发生于大阴唇 2例 ,小阴唇 1例 ,外阴部 1例。巨检送检4例标本均为扁圆形肿物 ,肿瘤大小 :1.6 cm× 1.2 cm× 0 .5 cm～ 3.8cm×3.1cm× 1.0 cm。 3例肿瘤有完整包膜 ,1例包膜欠完整但境界清楚。肿块切面均实性、灰白或灰褐色…     

血管肌纤维母细胞瘤临床病理分析

目的:观察并分析血管肌纤维母细胞瘤(angiomyofibroblastoma,AMF)的临床病理特点、影像学特征及治疗方法和预后.方法:回顾分析2015年至2019年诊断的5例AMF患者的临床资料,观察其临床特征、病理形态学特点及免疫组化结果等.结果:5例患者均为生育期女性,肿瘤位于外阴,临床以及实验室检查均缺乏特征...     

血管肌纤维母细胞瘤六例报告并文献复习

血管肌纤维母细胞瘤(angiomyofibroblastoma,AMF)是一种少见的软组织良性肿瘤,好发于成年女性外阴部,1992年由Fletcher等[1]首先报道和描述.由于该肿瘤发现和命名较晚,组织形态学不典型,临床和病理医师对其诊断和鉴别诊断还不是很熟悉,容易和其他几种相似的软组织肿瘤相混淆.近年来陆续有少量病例报道,经文献检索国内外报道约100多例,而肿瘤内富含成熟脂肪组织的脂肪瘤样变异型更为罕见,国外报道有7例[2].本研究总结AMF6例包括罕见的脂肪瘤样变异型1例,观察其临床病理特点及免疫组化特征并结合文献复习,以期提高对AMF的认识和病理诊断水平.     

骨原发性恶性淋巴瘤临床病理及免疫组化研究

[目的]对7例骨原发性恶性淋巴瘤（PLB）进行临床病理、免疫组化研究,以探讨其在诊断及鉴别诊断上的意义。[方法]标本采用常现石蜡切片、HE染色及ABC法免疫级化染色,光镜观察。[结果]患者以男性多见（6/7例）,好发于扁骨。多数为B细胞性淋巴瘤（5／7例）,T细胞性淋巴瘤（1/7例）和组织细胞性淋巴瘤（1／7例）少见。免疫组化染色7例瘤细胞均表达LCA阳性,其中5例表达126阳性,1例UCHL1阳性,1例MAC387阳性。（结论）PLB较罕见,多为B细胞性。其起源可能与骨髓内B淋巴细胞恶变有关。其应与骨内其它原发性或继发性小细胞性恶性肿瘤相鉴别,免疫组化染色对骨PLB诊断、分型及鉴别论断均有重要的意义。     

Vulvar Paget's disease and stromal invasion: Clinico-pathological features and survival outcomes

PURPOSETo evaluate clinico-pathological features, treatments and survival outcomes of vulvar Paget's disease (VPD).MethodsWe retrospectively reviewed VPD diagnosed between 1983 and 2018 at the Department of Surgical Sciences, Sant’Anna Hospital, Turin. Clinico-pathological characteristics and surgical treatment outcomes were investigated according to the depth of invasion.ResultsA total of 122 patients were identified. Eighty-seven patients were diagnosed with intraepithelial VPD, 22 with microinvasive (<=1 mm) VPD and 16 with invasive VPD. The median follow-up was 94.6 months (interquartile range 25th-75th, 26–120). Most of patients 95/122 (77%) were treated by surgery. Local recurrence was observed in 69/95 (73%) patients without significant difference between the 3 groups (p = 0.33), however, total vulvectomy showed better local control in microinvasive and invasive VPD than in intraepithelial tumors. At 120 months the cancer-specific survival was 100% for intraepithelial and microinvasive VPD versus 31% for invasive VPD (log-rank p = <0.0001) Age ≥65 years (OR: 4.17 CI 1.12–15.5, p = 0.03) and VPD's area ≥15 cm² (OR: 5.83 CI 1.75–19.3, p = 0.004) were associated with risk of invasiveness.ConclusionMicroinvasive VPD has an identical prognosis to intraepithelial VPD, suggesting the omission of lymphadenectomy or adjuvant treatments are safe in this subset of patients. We recommend caution to propose medical treatment in patients who are ≥65 years old and with wide tumor area, as they are at the greatest risk of invasiveness.     

p63、p73在外阴鳞癌中的表达及临床意义

目的探讨p63、p73蛋白在外阴鳞状上皮细胞癌发生发展中的作用。方法应用免疫组化技术检测p63、p73蛋白在20例正常外阴组织,30例外阴上皮内肿瘤组织以及44例外阴鳞状上皮细胞癌组织中的表达水平。结果 p63和p73蛋白在正常外阴组织,外阴上皮内肿瘤组织及外阴鳞癌组织中均可表达。在正常外阴组织,外阴上皮内肿瘤组织及外阴鳞癌组织中p63和p73阳性表达率呈递增趋势。p63表达与手术病理分期和腹股沟淋巴结转移情况有关,p73表达与腹股沟淋巴结转移情况有关。p63和p73蛋白在外阴鳞癌中的表达呈正相关（γs=0.438,P=0.03）。结论在外阴鳞癌中,p63和p73蛋白表达均明显增强,两者异常表达与外阴鳞癌恶性生物学行为密切相关。p63和p73共同参与外阴鳞癌发生进展。     

Early and Late Complications after Inguinofemoral Lymphadenectomy for Vulvar Cancer

Background: We aimed to determine the frequency of early and late complications following groin surgeryfor vulvar cancer and analyze possible risk factors. Materials and Methods: This retrospective cohort studyincluded 99 women who underwent for vulvar cancer. The early (≤1 month) complications were wound infection,breakdown and lymphocyst and late (>1 month) complications were lower limb lymphedema, incontinence anderysipelas. The risk factors for developing each of the complications were analyzed with regression analysis.Results: In the entire cohort, 29 (29.3%) women experienced early and 12 (12.1%) had late complications.Wound complications including infection and breakdown were the leading early complications (23.2%). In themultivariate analysis, both obesity (body mass index ≥30 kg/m2) and advanced age (≥65 years) were found asindependent predictive factors for early complications. Obese women of advanced age had 6.32 times more riskof experiencing any of the early complications, when compared to non-obese and young women (55.6% vs 8.7%).The most common late complication was lower limb lymphedema (10.1%) that was more frequently seen in youngwomen. However, neither age nor lymph node count were significantly associated with the occurrence of lowerlimb lymphedema. Conclusions: More than 40% of the women suffered from postoperative complications afteringuinofemoral lymphadenectomy in the current study. While advanced age and obesity were the significantpredictors for any of the early complications, there was no identified risk factor for lower limb lymphedema.     

脑原发性恶性淋巴瘤临床病理分析

目的:研究脑原发性恶性淋巴瘤(PMLB)的临床病理和免疫表型。方法:对9例脑原发性恶性淋巴瘤作了临床病理形态观察和免疫组化分析(EnVision法)。结果:8例为非霍奇金B细胞淋巴瘤,1例为T细胞淋巴瘤。瘤细胞以中心或中心母细胞为主,伴浆样分化,大多围绕血管排列。结论:脑原发性恶性淋巴瘤的临床病理特征具有其独特性,脑淋巴瘤的确诊依赖于病理形态和免疫组化。     

宫颈小细胞神经内分泌癌临床病理分析

目的:探讨宫颈小细胞神经内分泌癌(small cell neuroendocrine carcinoma of the cervix,SCNCC)的临床病理和免疫表型。方法:复习4例SCNCC的临床病理资料,并将其组织学特征、免疫表型和预后与宫颈鳞癌进行比较。结果:SCNCC的发病年龄平均38.5岁,多表现为接触性出血或阴道不规则流血、排液。组织学特征为肿瘤细胞小而圆,胞质少,核染色质深染,核仁不明显,分裂象多见,可见坏死,肿瘤细胞呈片状浸润。免疫表型显示4例均表达至少一种神经内分泌标志。4例SCNCC的发病年龄低于宫颈鳞癌,淋巴结转移率高于宫颈鳞癌,近期随访结果显示预后较宫颈鳞癌差。结论:宫颈小细胞神经内分泌癌是一种少见的高度恶性肿瘤,具有独特的病理形态特征,预后较差。免疫组化染色有助于确诊。     

乳腺非何杰金淋巴瘤8例临床病理及免疫表型分析

本文对6例原发及2例继发乳腺NHL进行报道分析。临床易误诊为乳腺癌．在部分病例镜下可见到淋巴上皮病损。本组组织学类型大多为高度恶性。免疫级化示：原发组6例中4例为B细胞性，1例为T细胞性．1例来定；继发2例均为B细胞性。本研究示：原发与继发乳腺NHL主要靠临床区别，组织学形态难以鉴别；至少部分乳腺NHL与粘膜相关淋巴组织有关；年轻妇女乳腺NHL预后差。     

肝原发性血管肉瘤（附三例报告）

本文报告了３例肝原发性血管瘤，男性２例，女性１例，平均年龄３２．７岁，占同期肝脏恶性肿瘤检出率的０．６８％（３／４３６），临床表现为上腹痛及包块，血清ＨＢｓＡｇ及ＡＦＰ阴性，本组资料还进行了网状纤维染色及免疫组织化学标记，本文讨论肝血管肉瘤的临床病理特点，诊断及鉴别诊断。     

Clinical Application of Endoscopic Inguinal Lymph Node Resection after Lipolysis and Liposuction for Vulvar Cancer

Aim: To examine lymph nodes obtained after lipolysis and liposuction of subcutaneous fat of the inguinalregion of female vulvar cancer patients to explore the feasibility of clinical application. Methods: The field ofoperation was on the basis of the range of the conventional resection of inguinal lymph nodes. We injected lipolysisliquid fanwise, started liposuction after 15-20 minutes; then the subcutaneous fatty tissue was sucked out clearlyby suction tube. We selected the first puncture holes located on 2-3 cm part below anterior superior spine, theothers respectively being located 3cm and 6cm below the first for puncturing into the skin, imbedding a trocarto intorduce CO₂ gas and the specular body, and excise the lymph nodes by ultrasonic scalpel. The surgicalfield chamber was set with negative pressure drainage and was pressured with a soft saline bag after surgery.Results: A lacuna emerged from subcutaneous of the inguinal region after lipolysis and liposuction, with a widefascia easily exposed at the bottom where lymph nodes could be readily excised. The number of lymph nodesof ten patients excised within the inguinal region on each side was 4-18. The excised average number of lymphnodes was 11 when we had mature technology. Conclusion: Most of adipose tissue was removed after lipolysisand liposuction of subcutaneous tissue of inguinal region, so that the included lymph nodes were exposed andeasy to excise by endoscope. This surgery avoided the large incision of regular surgery of inguinal region, theresults indicating that this approach is feasible and safe for used as an alternative technology.