软组织恶性纤维组织细胞瘤的治疗

发生于软组织的恶性纤维组织细胞瘤１２例，平均年龄６１．９岁，平均随访２９个月。本病与发生在骨组织的恶性纤维组织与细胞瘤不同，病理学还可分为席纹样－多形性型。粘样型。巨细胞型，黄色肉芽肿型，本病局部广泛切除可以得到较好的治疗。综合治疗特别放疗及化疗药物的应用，对减少复发，治疗转移有一定的疗效。     

12例肺恶性纤维组织细胞瘤的诊断与治疗

对肺恶性纤维组织细胞瘤１２例进行了回顾性分析，旨在提高对其临床表现、诊断和外科处理的认识。结果本组病人病程长短差异较大，胸部Ｘ线、ＣＴ检查缺乏特征性表现，气管镜及痰脱落细胞学检查阳性率不高，术后局部复发率为３３．３％，远处转移率为４１．７％，３年生存率为２５％。结论：肺恶性纤维组织细胞瘤应以手术治疗为主，如能早期诊断，彻底切除并配合放、化疗综合治疗，可望改善其不良预后，提高治疗效果     

肾脏和膀胱恶性纤维组织细胞瘤(附三例报告)

目的：报道3例泌尿系恶性纤维组织细胞瘤。方法：总结2例肾脏、例膀胱恶性纤维组织细胞瘤患者的临床资料。结果：3例均行手术切除。术后病理和免疫组化证实为恶性纤维组织细胞瘤。2例分别于术后4、7个月死亡,1例现已存活2年6个月。结论：此病诊断困难,术前难与原发性肾癌和膀胱癌相鉴别,免疫组化有助于区别癌、肾肉瘤样癌或肾母细胞瘤。     

肢体软组织恶性纤维组织细胞瘤

作者总结１１例发生于软组织的恶性纤维组织细胞瘤，男３例，女８例，平均年龄３１岁，平均病期７个月，随访６年。本病与发生在骨组织的肿瘤在临床方面表现为发病部位的不同，局部软组织肿物生长较快，形成结节，发生溃疡时呈菜花样外观。病理学表现出典型的成纤维细胞及组织细胞特征，胶原纤维排列成漩涡状，细胞核有异型性，有分裂相。本病预后较一般肉瘤要好，局部扩大切除范围可以得到根治性治疗。在随访过程中未发现有远处转移的病例。     

软组织恶性纤维组织细胞瘤22例临床分析

软组织恶性纤维组织细胞瘤２２例临床分析河北医科大学第三医院（０５００５１）宋朝晖吕鹏飞肖文华河北省人民医院（０５００５１）白晓谊本文就我院近年收治发生在软组织中的恶性纤维组织细胞瘤２２例，结合文献对该病的诊治问题进行分析讨论。１临床资料１．１一般资料...     

脊柱恶性纤维组织细胞瘤临床诊治16例报告

目的：探讨脊柱恶性纤维组织细胞瘤的临床特点及其手术方式。方法：1996～2001年收治16例脊柱恶性纤维组织细胞瘤患者(平均年龄47岁)，经临床及影像学诊断确诊后采取手术治疗。肿瘤位于颈椎者1例，行前路肿瘤切除钢板同定；位于胸椎者6例，采用经胸人路行肿瘤切除、植骨或骨水泥椎体重建加Z—plate内固定；位于腰椎者3例，采用后路、侧方入路或胸腹联合入路行肿瘤切除、植骨或骨水泥椎体重建、后路椎弓根、Kaneda等内固定方法；位于骶椎者4例，采用TSRH腰椎骨盆内固定重建术，2例患者仅行肿瘤切除术。术前、术后均进行化疗。术后对患者疼痛情况、影像学表现等进行随访，平均随访2．5年。结果：术中平均出血量2306ml，所有患者平均疼痛下降2．19级，7例有肿瘤复发(43．75％)。未发现椎体塌陷和内固定失败。随访中全组均存活。结论：在胸腹腔等部位生长的肿瘤容易形成巨大软组织肿块，术中出血较多。根据肿瘤的不同部位，在肿瘤切除后，可以采用不同形式的椎体重建和内固定。术前术后应联合化疗。     

肾脏恶性纤维组织细胞瘤二例报告

例1 男,56岁.因乏力、纳差3个月,低热1个月,于1988年3月5日人院.既往无腰痛、血尿、膀胱刺激征.体检:右肋缘下触及 4cm×5cm肿块,质硬,活动,表面不平.B超示右肾14.8cm×8.5cm×8.7cm,中下部探及8.5cm×9.0cm肿块.边界尚清晰,未见完整包膜,内部回声不均匀.腹部平片示右肾区L_2平面数枚点状钙化,右肾轮廓不清.静脉尿路造影示右肾盂肾盏形态不规则,下盏受压,向上移位.CT报告右肾增大、变形,除上极少许正常肾组织外,大多为肿瘤占据.肿块9.5cm×8.2cm×12.0cm,密度不均,有部分钙化灶及坏死液化区,无明显增强效应,部分断层可见病变与腰大肌粘连.血     

肿瘤干细胞与恶性纤维组织细胞瘤的治疗进展

肿瘤干细胞是肿瘤组织中存在的一部分具有干细胞性质的亚群,他们具有自我更新、无限增殖和多向分化的潜能。肿瘤干细胞理论认为肿瘤难以根除是因为肿瘤干细胞的存在。恶性纤维组织细胞瘤是一种常见的恶性肿瘤,术后复发率极高,目前其根除仍是一个难题。现已有文章报道分离出了恶性纤维组织细胞瘤中的肿瘤干细胞,这无疑给根除恶性纤维组织细胞瘤带来了新的希望。     

恶性纤维组织细胞瘤的整形外科治疗

目的 探讨恶性纤维组织细胞瘤的手术及修复方法,以求最佳的治疗效果.方法 对7例恶性纤维组织细胞瘤患者行以手术治疗为主的综合治疗,并对病理类型、手术及修复方法 进行探讨.结果 所有7例患者术后恢复良好,生活质量得到明显提高.经2～3年随访,局部复发2例,占28%.结论 恶性组织细胞瘤的治疗,根治切除是关键,术后再辅以放疗、化疗等综合治疗.术后应根据肿瘤类型、部位及患者一般状况,选择不同修复方法.     

肾脏和前列腺恶性纤维组织细胞瘤三例报告

目的 提高对肾脏、前列腺恶性纤维组织细胞瘤（malignant fibrous histiocytoma，MFH）的认识。方法 MFH患者3例，均为男性。2例原发性肾脏MFH者年龄为69、73岁，临床表现为低热或腰部疼痛、消瘦，B超及CT示肾脏实性占位性病变，分别为8．0cm×7．0cm、7．4cm×6．6cm。1例原发性前列腺MFH患者年龄39岁，临床表现为排便困难，B超及CT示前列腺内囊实性占位性病变18．1cm×14．5cm。结果 3例分别行根治性左肾切除术、左肾切除加局部浸润组织切除、膀胱前列腺切除术加直肠切除术加乙状结肠造瘘术。首次手术均完整切除肿瘤。光镜下见肿瘤细胞常排列成席纹状，形态多样，主要由梭形的纤维母细胞样细胞和圆形、卵圆形组织细胞样细胞组成，并有不等量的多形性巨细胞及炎细胞。免疫组化染色示vimentin、-AAT、α1—ACT、CD68（＋），EMA、Desmin、S-100（-）。2例肾脏MFH患者分别于首次术后16、21个月因纵隔广泛转移或局部复发伴腹腔转移死亡，前列腺MFH患者术后3个月因肿瘤肺转移死亡。结论 原发性肾脏和前列腺MFH是一类罕见的、高度恶性的肿瘤，预后差，确诊需依赖组织病理学及免疫组织化学检查，早期诊断及原发病灶的彻底切除是治疗的关键。     

Malignant fibrous histiocytoma of soft tissue

Summary Two cases of malignant fibrous histiocytoma are presented. The clinicopathologic findings are also reported. The disease was of fast growing pattern and the outcome of one of the cases very rapid. The relative literature is reviewed and the histogenesis is emphasized.     

Malignant fibrous histiocytoma of the trachea

We experienced a rare case of malignant fibrous histiocytoma (MFH) arising in the trachea. A 24-year-old man with severe dyspnea had a well-defined mass in the cervical trachea on chest X-ray examination. Chest computed tomography showed a 2.0-cm diameter mass originating in the right-posterior wall of the trachea. The tumor occupied over 90% of the lumen. A radical excision of the tumor (tracheal resection) with tracheal plasty was performed. The microscopic diagnosis was MFH. The patient remains well, without evidence of recurrence, 3 months after surgery.     

Malignant fibrous histiocytoma in the anterior mediastinum

The origin of a malignant fibrous histiocytoma in the anterior mediastinum is rare. A 71-year-old man was referred to our department for treatment of a tumor 15 cm in diameter originating in the anterior mediastinum. Malignant fibrous histiocytoma was suspected after a percutaneous needle biopsy. Systemic screening showed no other organ involvement, and the tumor was considered to be a primary mediastinal tumor. The tumor, resected through a median sternotomy, was well encapsulated and resection was complete. The pathological diagnosis was malignant fibrous histiocytoma originating in the anterior mediastinum.     

Malignant fibrous histiocytoma of the stomach: Report of two cases

(Received for publication on July 8, 1996; accepted on May 12, 1997)     

Malignant fibrous histiocytoma originating in the mediastinum: Report of a case

Malignant fibrous histiocytoma (MFH) is a tumor which most often develops in the soft tissues of the extremities and retroperitoneum, but very rarely originates in the mediastinum. We report herein the case of a 63-year-old man who underwent surgical resection of a rapidly growing tumor in the right thoracic cavity which was diagnosed as an MFH of mediastinal origin on the basis of histological findings, the definitive diagnosis ultimately being made by specific immunostaining.     

Mediastinal malignant fibrous histiocytoma developing from a foreign body granuloma

A patient with mediastinal malignant fibrous histiocytoma (MFH) apparently developing from a foreign body granuloma is reported. A 72-year-old man was admitted to our hospital complaining of generalized fatigue and palpitations. He had undergone surgery for pulmonary tuberculosis 46 years previously. Radiography and computed tomography of the chest showed a round 5-cm mass with marginal calcification in the right side of the anterior mediastinum. The mass was resected completely via median sternotomy. Intraoperative diagnosis of foreign body granuloma was made, based on gauze fragments found in the mass and intraoperative pathologic findings suggesting benign granulation tissue. The postoperative histopathologic diagnosis was myxoid MFH. To our knowledge, mediastinal MFH developing from a foreign body granuloma has not been reported previously.     

Malignant fibrous histiocytoma of the spermatic cord: A case report

We present a case of malignant fibrous histiocytoma of the spermatic cord. An 86-year-old man was admitted to the hospital with a right painless scrotal mass. Under the diagnosis of a testicular tumor, right radical orchiectomy was performed. Grossly, the tumor firmly adhered to the spermatic cord. The right testis and epididymis were normal. The histologic diagnosis was malignant fibrous histiocytoma. There was local recurrence 2 months after surgery. The recurrent tumor was resected with the surrounding soft tissue, but the patient died 5 months after the initial operation.     

Malignant fibrous histiocytomas in children

The natural history of malignant fibrous histiocytomas in children has not been well delineated. During a 6-year period, we have treated six patients less than 18 years of age. The sites of origin included the retroperitoneum in 2 patients, neck in 2 patients, and extremities in 2 patients. Surgical treatment consisted of wide local excision in 5 patients and amputation in 12; radiation and/or chemotherapy were administered to 2 patients following resection of all tumor. All children remain free of local recurrence or distant metastases with a median follow-up in excess of 4 years. These data suggest that malignant fibrous histiocytomas in children may have a better prognosis than in adults.     

Malignant fibrous histiocytoma of the right spermatic cord: A case report

The patient was a 47-year-old male, who visited Hidaka Hospital with a chief complaint of swelling in the right inguinal region and the scrotum. With a diagnosis of a right spermatic cord tumor, right high orchiectomy was performed. Since an inflammatory type of malignant fibrous histiocytoma (MFH) was diagnosed from histopathological findings, chemotherapy and radiation therapy were performed as postoperative treatment. Malignant fibrous histiocytoma with the primary focus of the spermatic cords is a rare disease. To our knowledge, this is the 20th case of MFH of the spermatic cord in Japan (the 42nd in the world) and it is the second case of inflammatory type of MFH in Japan.