孤立性纤维性肿瘤48例临床病理特征分析

【摘要】 目的探讨孤立性纤维性肿瘤(solitary fibrous tumor,SFT)的临床病理特征、鉴别诊断及预后。方法对48例SFT病例行病理学观察及免疫组化染色,结合临床及随访资料进行分析。结果发生于胸膜4例,胸膜外44例。良性38例,恶性10例。组织学形态多样,典型者见梭形细胞呈无模式(patternless)排列,伴有粗大瘢痕样的胶原及血管外皮瘤样结构。免疫组化染色Vimentin、CD34、Bcl-2、CD99、SMA阳性率分别为100%、94%、79%、67%和5%,Desmin、S-100、CD117、Calretinin及EMA均为阴性。随访36例,33例无瘤生存,3例复发。结论 SFT可发生于全身各处,临床病理特征和免疫组化表型有助于诊断及鉴别诊断。组织学形态并不能完全准确地反映生物学行为,有必要对患者进行术后长期随访。更多还原

【Abstract】 Objective To investigate the clinicopathologic characteristics,differential diagnosis and prognosis of solitary fibrous tumor(SFT).Methods Clinic and follow-up data were analyzed with results of pathologic and immunohistochemical examination of 48 cases of SFT.Results Among 4 cases of pleural SFT and 44 cases of extra-pleural SFT,38 benign and 10 malignant cases were identified.The histological spectrum of SFT is broad and characterized by patternless arrangement of bland-looking spindly cells accompanied with thick keloid collagen and haemangiopericytoma-like architecture.The positive rates of Vimentin,CD34,Bcl-2,CD99 and SMA were 100%,94%,79%,67% and 5% respectively.Desmin,S-100,CD117,Calretinin and EMA were all negative.Follow-up information on 36 cases revealed that 3 patients had had relapse and the other 33 patients were alive.Conclusion Solitary fibrous tumor may occur in various sites of the body.The clinicopathologic features and immunohistochemical profile are helpful to identify SFT.The biologic behavior is not always consistent with its histology;long-term clinical follow-up therefore is required for all SFTs.更多还原