胶原纤维瘤的病理学及MRI特征(3例报告及文献复习)

目的 总结胶原纤维瘤的病理学及MR I特征,分析其诊断价值。方法 1997年1月-2007年1月共收治胶原纤维瘤3例,均予切除,总结其MR I特点、形态学观察及免疫组化特征。结果 MR I观察肿瘤边界清楚,质地均匀,呈内中散在的圆形高信号影。镜下观察显示,肿瘤由稀疏的梭形或星状纤维母细胞和大量致密或纤维粘液样的间质组成。免疫组织化学标记显示瘤细胞表达波形蛋白,部分表达平滑肌肌动蛋白、肌特异性肌动蛋白和结蛋白,不表达CD34、细胞角蛋白和S-100。结论 胶原纤维瘤是一种具有独特临床病理学特征的良性纤维母细胞性肿瘤,MR I有助于诊断,而进一步确诊依赖于组织学免疫组化检查。

The Pathological and MRI Characteristics of Collagenous Fibroma

Objective To study the clinical MRI and pathological characteristics of collagenous fibrom, and assess their diagnostic values. Methods Three cases of collagenous fibrom were evaluated by MRI and light microscopy, immunohistochemistry. All cases received tumor resection. Results The MRI image showed well-circumscribed, homogeneous, and high signals. Histological exam showed sparse spindle or stellat- e-shaped fibroblast embedded in densely fibrous or fibro-myxoid stroma. The neoplastic fibroblastic ceils resembled the reactive fibroblasts by containing fine chromatin and small distinct nucleoli without cellular atypia or mitotic figures, lmmunohistochemical results showed diffuse and strong immunoreactivity for vimentin, focal staining for a-smooth muscle actin, muscle-specifc actin and desmin, but the carcinoma cell did not express CD34, cytokerratin and S-100 protein. Conclusion Collagenous fibrom is a benign fibroblastic neoplasm with distinctive clinical MRI and pathological characteristics. MRI could conduce to diagnosis, nevertheless the final diagnosis should be based on immunohistochemical examination results.