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结节性筋膜炎35 例报道并文献复习[J]. 肿瘤防治研究, 2007, 34(02): 140-142. DOI: 10.3971/j.issn.1000-8578.1545
引用本文: 结节性筋膜炎35 例报道并文献复习[J]. 肿瘤防治研究, 2007, 34(02): 140-142. DOI: 10.3971/j.issn.1000-8578.1545
Nodular Fasciitis :Report of 35 Cases and Review of the Literature[J]. Cancer Research on Prevention and Treatment, 2007, 34(02): 140-142. DOI: 10.3971/j.issn.1000-8578.1545
Citation: Nodular Fasciitis :Report of 35 Cases and Review of the Literature[J]. Cancer Research on Prevention and Treatment, 2007, 34(02): 140-142. DOI: 10.3971/j.issn.1000-8578.1545

结节性筋膜炎35 例报道并文献复习

Nodular Fasciitis :Report of 35 Cases and Review of the Literature

  • 摘要: 目的 探讨结节性筋膜炎(Nodular fasciitis,NDF)的临床和病理特征、亚型及免疫表型。方法 应用光镜、免疫组化方法观察35例NDF病理组织学特点,分析临床资料并文献复习。结果 NDF多见于20-40岁青壮年;好发于全身皮下组织,常见于上肢和躯干;临床表现以生长迅速和体积较小为其特征。临床亚型以皮下型最多见。病理组织学特点为增生活跃的纤维母细胞呈束状、半漩涡状或S形排列,无多形性细胞,核分裂易见;疏松的黏液样基质;丰富的血管及红细胞外渗,以及不规则组织裂隙等。组织学亚型有4型:粘液型(10例)、肉芽肿型(15例)、巨细胞型(2例)、纤维瘤型(8例),分别反映病变的早期、中期和晚期。免疫表型显示Vimentin、SMA、MSA阳性表达,S-100和CD34阴性表达。结论 NDF是一种纤维母细胞/肌纤维母细胞增生性病变,病理形态复杂,成分多样,熟悉其临床特征和组织学构型,可避免误诊为肉瘤。

     

    Abstract: Objective  To study the clinical and pathological characteristics, subtypes and immunophenotypes of nodular fasciitis. Methods  The histopathological features of 35 cases of nodular fasciitis were observed using light microscopy and immunochemistry, then clinical data was analyzed and the literature was reviews. Results  Nodular fasciitis (NDF) occurs in all age groups but more often in young adults of 20 to 40 years old. The lesion is usually any part of the body's subcutaneous and of ten locates in upper extremity and trunk, clinically, NDF typically grows rapidly and of ten small sizes. Histopathologically, it is composed of plump fibroblasts or myofibroblasts, which of ten grow in S-shaped, fascicles or semicircinate pattern, lacking pleomorphic cells and easy to see mitoses. The lesion has loose and myxoid stroma, abundant vessels, ext ravasated red cells and irregular cranny, which is important features conduced to diagnose. Histologicly, there are 4 subtypes : myxoid NDF(10 cases), granulomatous NDF(15cases), giant cell NDF(2 cases) and fibromatous NDF(8 cases), which represent the disease's early, middle and later stages changes respectively. Immunophenotype demonst rates the vimentin, SMA and MSA are positive in tumor cells but S-100 and CD34 are negative. Conclusion  NDF is a complex lesion, in which fibroblasts or myofibroblast s are hyperplasia and its component s are multiplex. So mastering the lesion's clinical features, histopathological configuration and immunophenotype can prevent the mistakes in diagnosis of sarcoma.

     

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