20例易误诊结节性筋膜炎患者的临床病理分析

目的 探讨20例易误诊结节性筋膜炎患者的临床病理特征.方法 选取2013年2月至2015年12月在本院接受结节性筋膜炎治疗的20例患者,采用巨检和镜检两种方式进行病理分析.结果 结节性筋膜炎多发于20 ～ 58岁中青年人群,可发生于全身皮下组织,上肢及躯干最为常见.病理分析可得,结节性筋膜炎生长迅速,增生活跃的肌纤维母细胞呈束状、交织状或紊乱无方向排列,易见核分裂,存在丰富的血管及红细胞外渗和疏松的黏液样基质,根据镜检结果分为三种亚型,黏液瘤型(12例)、肉芽肿型(6例)、纤维瘤型(2例).免疫表型显示,MSA、SMA、Vimentin呈阳性,S-100、CD68、CD34表达呈阴性.结论 对于结节性筋膜炎患者而言,在进行临床病理分析的同时需结合患者自身具体的病情和组织学形态进行分析,避免过度诊断或诊断不足造成的误诊,耽误患者治疗.

Clinical pathology of 20 cases of easily-misdiagnosed nodular fasciitis

Objective To investigate the clinical pathological features of20 cases ofeasily-misdiagnosed nodular fasciitis.Methods 20 patients with nodular fasciitis treated at our hospital from February,2013 to December,2015 were chosen and pathological analyzed by macro-examination and microscopic examination.Results nodular fasciitis occurs mainly in 20-58 years old persons and could occur in systemic subcutaneous tissue and most common in upper limbs and trunk.Pathological analysis showed that nodular fasciitis grown fast,the active proliferation of myofibroblasts was fascicular,interlace or disorder without direction,mitoses was common,myxoid matrix had abundant vascular extravasation and osteoporosis and red blood cells.According to the examination results,they were divided into three subtypes-tumor type (12 cases),granuloma type (6 cases),and tumor type (2 cases).Immunophenotype showed that MSA,SMA,and Vimentin were positive and the expressions of S-100,CD68,and CD34 wcre negative.Conclusions For patients with nodular fasciitis,clinical pathological analysis and morphological analysis combined with the specific condition and the patient's own tissue can avoid misdiagnosis or excessive diagnosis caused by the lack of diagnosis and delaying treatment.