外阴深部侵袭性血管黏液瘤临床病理观察

目的]探讨外阴深部侵袭性血管黏液瘤的临床病理学特征.方法]对2例外阴血管黏液瘤进行光镜观察和免疫组化检测.结果]大体肿瘤为分叶状,组织学上肿瘤由梭形或星形细胞组成,胞浆少,核圆形或卵圆形,浅染,有中位小核仁,无核分裂相;肿瘤细胞密度低至中等,散在分布于黏液样或胶原纤维背景中,同时伴有不同管径的血管出现.免疫组化示肿瘤细胞阳性表达vimentin、desmin、PR,而actin、SMA、MSA、ER、S-100、CD34均阴性.结论]外阴血管黏液瘤是一罕见、具有局部侵袭性的软组织肿瘤,WHO将其归为行为不确定的肿瘤,偶尔与血管肌纤维母细胞瘤等在形态上有重叠,通过仔细的组织学观察不难区分,此瘤通过手术局部扩大切除为佳,部分病例可局部复发.

Clinicopathologic Observation on Aggressive Angiomyxoma in Deep Vulva

Objective] To explore the elinicopathologic characteristics of aggressive angiomyxoma in deep vulva. Methods] Two cases of aggressive angiomyxoma in deep vulva were studied with light microscope and immunohistochemical method. Results] In general, the tumor was lobulated shape. In histology, the tumor was composed of fusiform or star cell with less cytoplasm. The nuclei were round or oval shape with light staining and median small nucleoli and without mitoses. The density of tumor cell was low to medium, and dispersively distributed in mucoid or collagen, and accompanied by vessels with different diameters. Immunohisto- chemical analysis showed that tumor cells were positive for vimentin, desmin and PR, but negative for actin, SMA, MSA, ER, S-100 and CD34. Conclusion] Vulva angiomyxoma is a rare soft tissue tumor with local invasion, and classified as the tumor with uncertain behavior by WHO. It is occasionally overlaped with angio- myo fibroblastoma in morphology, but it is not difficult to be distinguished by careful histological observation. Local expansive resection surgery is good for the tumor. Some cases will have local recurrence.