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。

Angiomyofibroblastoma: Report of 2 cases and review of the literature

Purpose To study the clinicopathological features, diagnosis and differential diagnosis of angiomyofibroblastoma(AMF). Methods Two cases of AMF were examined by light microscopy and immunohistochemical study. The antibodies were used vimentin,desmin,SMA,S 100 protein,CD34,ER,PR and CK. Results One case occurred in a 30 year old female, presenting as a vulval cyst; the other one appeared as a spermatic cord mass of inguinal region,arising in a 51 year old male patient.On histological examination,the tumors were well circumscribed and characterized by alternating hypercellular and hypocellular areas with abundant blood vessels.The proliferating vessels were thin walled and capillary to middle sized.The tumor cells were arranged in cords and nests preferentially arrayed around vessels and rarity of erythrocyte extravasation. There were groups of fat cells dispersed in one case in the tumor stroma. Immunohistochemically, the tumor cells were positive for vimentin(2/2),ER(2/2), PR(2/2),SMA(1/2),CD34(2/2), and focal reaction for SMA(1/2), S 100 protein(1/2),and negitive for desmin and CK. Conclusions AMF is a rare mesenchymal tumor predominantly in vulvagenital location.The origin remains undetermined, but it is suggested that an origin from a perivascular pluripotent stem cell that is capable of myofibroblastic differentiation. Base on these histologic features, it is to distinguish AMF from aggressive angiomyxoma, cellular angiofibroma, superficial angiomyxoma, fibroepithelial stromal polyp and spindle cell lipoma.