盆腔孤立性纤维瘤1例并文献复习

目的:探讨盆腔孤立性纤维瘤的临床和病理特征、诊断和鉴别诊断、治疗以及预后。方法:对1例盆腔孤立性纤维瘤的临床和病理、影像学表现、诊断和鉴别诊断及治疗方式等进行探讨。结果:手术标本肉眼观:肿瘤包膜完整,表面光滑,切面灰白,质嫩;镜下观:主要由梭形细胞组成,肿瘤细胞丰富伴轻度异型,核染色质粗,核分裂像分布不均匀,由细胞致密区和疏松区交替无特定结构排列,灶性区可见坏死,低度恶性,间质血管较丰富,细胞间可见大量胶原纤维;免疫组织化学:CD34+,CD31+,Bcl-2凋亡蛋白±,细胞增殖相关抗原20%+,细胞角蛋白-,钙视网膜蛋白-,CD99抗原-,肌间线蛋白-,p53-,S-100+,平滑肌肌动蛋白-,波形蛋白+,WT-1蛋白-。结论:孤立性纤维性肿瘤无特异性临床表现,诊断主要依据病理形态学特征和特异性标志物的免疫组织化学检测;需与其他梭形细胞瘤鉴别;首选手术治疗,术后需进行密切随访。

Pelvic solitary fibrous tumor in 1 case and literature review

Objective:To investigate the clinical and pathological features,diagnosis and differential diagnosis,treatment and prognosis of pelvic solitary fibrous tumor. Methods:The clinical and pathological features, diagnosis and differential diagnosis, treatment and prognosis of pelvic solitary fibrous tumor in a case were explored. Results:Complete capsule, smooth surface, gray cut-off and soft texture of tumor were observed under naked eye. Under microscopy,the tumor was mainly composed of spindle cells,mild dysplasia, coarse nuclear chromatin and uneven mitosis in tumor cells were detected,the tumor cells were alternatively arranged by hypercellularity and hypocellularity,and the necrosis with low potential malignancy,rich interstitial blood vessels and a large number of collagen fibers were found. The CD34+,CD31 +,B-cell lymphoma 2 ± ,antigen Ki-67 20% +,pan-cytokeratin antibody-,Calretinin-,CD99 -, Desmin-,MC-,p53-,S-100+,smooth muscle actin-,Vimentin+ and protein WT-1- were identified by immunohistochemistry. Conclusions:The solitary fibrous tumor has not specific clinical manifestations, the dignosis of which depends on the pathological features and detection of specific markers by immunohistochemistry. The tumor need to be identified with other spindle cell tumor, treated with operation and followed up after operation.