深部血管黏液瘤临床病理学观察

目的 探讨深部血管黏液瘤(DAM)的临床病理特征和鉴别诊断,提高诊治水平.方法 收集2000年1月至2008年12月间7例DAM,结合免疫组化和文献复习综合分析.结果 7例DAM,男:女:6:1,中位年龄48.5岁.肿瘤最大径半均5.9 cm.浸润性生长.瘤细胞稀疏分布于黏液样变性的胶原纤维基质中,呈星形、梭形.血管多量,厚薄不一.间质见肥大细胞和红细胞外渗.免疫组化:7例Vimenetin均强阳性,Desmin、ER、PR均不同程度的阳性.5例CD34和SMA阳性.S-100和CK均阴性.结论 DAM少见,好发子女件阴部.侵袭性和复发性是其主要的临床特点,易误诊或漏诊.免疫组化对确定DAM有所帮助,但对鉴别诊断意义不大.

Clinicopathological study of deep angiomyxoma

Objective To study the clinicopathologic features and differential diagnosis of deep angiomyxoma(DAM). Methods Seven cases of DAM were collected from 2000 to 2008. All the patients were examined by microscopy and immunohistochemistry. Results 6 patients with DAM were females and 1 was male, with median age of 48.5 years. Median maximum dimension was 5.9cm, with invasive growth pattern. The tumor cells of DAM were infantile, spindle or stellate,diffuse and nodular arrangement. A distinctive histologic feature of DAM was its vascularity. Non-arborizing, thin-wall, ectastic capillaries or more commonly, small thick-wall vessels were dispersed throughout the tumor. Mast cells and extravasated red blood cells were frequently found in the stroma, immunohistochemical study showed that 7 cases were positive for vimentin, desmin, ER and PR, 5 for CD34 and SMA, and negative for S-100 and CK. Conclusion DAM is a rare soft tumor that occurs principally in the vulval and vagina region of woman. Misdiagnosis has happened frequently. Immunohistochemical staining are helpful to diagnosis for DAM, but no significance to distinguish it.