【摘要】 目的探讨黏液纤维肉瘤(MFS)临床病理学特征、免疫表型及鉴别诊断要点。方法对4例MFS进行光镜观察和免疫组化标记,并进行文献复习。结果 MFS好发于中老年人,患者多以缓慢增大的皮下无痛性肿块就诊。镜下见肿块呈结节性生长,结节间为纤细而不完整的纤维结缔组织间隔。肿瘤由梭形或星状细胞和富含透明质酸的黏液样间质组成,可见特征性的弧线形血管和假脂肪母细胞。免疫组化显示瘤细胞vimentin(+),例2肿瘤细胞α-SMA和MSA(+),提示有肌纤维母细胞分化。结论根据瘤细胞的丰富程度、细胞核的异型性大小和核分裂的多少可将MFS分为低、中和高度恶性3种。大多数MFS为低度恶性,局部扩大切除即可,部分病例可复发或远处转移。更多还原

【Abstract】 Objective To investigate the clinicopathologic features,immunological phenotype and differential diagnosis of myxofibrosarcoma (MFS). Methods Four cases of MFSs were studied by light microscopy and immunohistochemistry; and literature was reviewed. Results MFS occurred predominantly in middle-aged persons,and patients manifested as a slowly increased and painless mass. Microscopically,the lesion grew with a nodular pattern,and there were thin and incomplete compartments fibrous connective tissue among nodes. The tumor was composed of fusiform or stellate tumor cells and myxoid stroma which was full of hyaluronic acid; and distinctively elongated,curvilinear capillaries and pseudo-lipoblasts could be noticed. Immunohistochemistry indicated that MFSs were not only positive for vimentin; but also for MSA and α-SMA in case 2,which suggested that the tumor cells were with myofibroblastic differentiation. Conclusion According to the cellulariry of neoplasm,nuclear heteromorphism and the number of mitotic figures,MFS can be divided into three subtypes:low grade,middle grade and high grade malignancy. Most of MFSs are low grade malignancy; and the expanded local excision is sufficient. Some cases could recur and metastasize distantly.更多还原