皮肤纤维瘤与隆突性皮肤纤维肉瘤的临床病理比较

对皮肤纤维瘤（DF）与隆突性皮肤纤维肉瘤（DFSP）在临床、组织形态及免疫组化等方面进行了比较。DF20例，平均年龄37.75岁，好发于四肢，平均直径0.8cm。瘤细胞呈束状或旋涡状排列，局部可见车辐结构。平均每50个高倍视野核分裂为0.75个。常伴组织细胞和炎细胞浸润、胶原增生、表皮增生及黑色素增多，CD34（－）。瘤细胞密度与胶原增生及炎细胞浸润呈负相关，提示DF可能为反应性病变。DFSP10例，平均年龄49.1岁，好发于躯干，平均年龄49.1岁，好发于躯干，平均直径3.23cm。瘤细胞呈典型的车辐状排列，平均每50个高倍视野核分裂为5.5个。肿瘤背景清晰，少数可见炎细胞浸润及表皮增生，无胶原增生及黑色素增多，CD34（＋）。这些临床及病理特征有助于两者的鉴别诊断。

Dermatofibroma versus dermatofibrosarcoma protuberans: a clinicopathologic comparison

The clinical, histological and immunohistochemical aspects ofdermatofibroma(DF) were compared with those of der matofibrosarcoma protuberans(DFSP). The average age of 20 patients with DF was 37.75 years, and the most common sites were extremities. The average diameter of the lesions was 0. 8cm. The tumor cells were arranged in bundle-form or whirl-like, and “cartwheel” pattern of spindle cell arrangement could be seen in focal areas. The mean mitotic figures were 0.75 per 50 high-power fields. The infiltration of histiocytes and inflammatory cells, collagen fiber proliferation, epidermal hyperplasia and increased melanin could be seen frequently. The density of tumor cells was negatively correlated to the proliferation of collagen fiber and infiltration of inflammatory cells. CD34 was negative. It suggests that DF is probable a reactive lesion. The average age of 10 patients with DFSP was 49. 1 years, and the majority of lesions was located on the trunk. The average diameter of the lesions was 3.23cm. The tumor cells were arranged in a typical “cartwheel” pattern. The mean mitotic figures were 5.5 per 50 high-power fields. The back ground of tumors was clear, and the infiltration of inflammatory cells and epidermal hyperplasia could be seen in a few cases. No collagen fiber proliferation and increased melanin were noted. CD34 was positive. These clinical and pathologic features are useful in the differential diagnosis between DF and DFSP.