摘要
目的 :探讨血管肌纤维母细胞瘤 (AMFB)的临床病理特点及与侵袭性血管粘液瘤 (AA)的鉴别。方法 :对 5例AMFB和5例AA进行临床病理和免疫组化研究 ,对 3例AMFB进行电镜观察。结果 :AMFB位于外阴或腹股沟区 ,肿瘤边界清楚 ,大小 0 .8～ 4cm。光镜 :肿瘤细胞呈梭形上皮样、束状及巢状排列 ,常围绕小至中等大小的薄壁血管周围。肿瘤有细胞密集区和细胞分散区。免疫组化 :肿瘤细胞表达vimentin ,desmin ,ER和PR。电镜 :肿瘤细胞有的可见胞质内微丝和致密体结构 ,有原始细胞间连接。 2例AMFB随访 2年无复发。而 5例AA中有 2例复发。AA肿瘤细胞侵袭性生长 ,细胞核有明显的裂隙 ,厚壁血管周围常有肌样嗜伊红条索 ,有更丰富的粘液样基质。结论 :AMFB和AA是具有不同临床病理特点的肿瘤 ,可能均起源于血管周围向肌纤维母细胞分化的干细胞 ,两者的鉴别目前主要依据病理形态学特征。
Purpose To explore the c1inicopatho1ogic features of angiomyofibroblastoma and the relationship between angiomyofibroblastoma (AMFB) and aggressive angiomyxoma(AA) Methods Five cases of AMFB and 5 cases of AA were reviewed Conventional histologic and immunohistochemical features of AMFBs were compared with those of AAs Results The lesions of AMFB were located in the superficial vulvar regional and inguinal areas The tumors were well delineated and ranged in size from 0 8 to 4 cm in dimension Microscopically, they were composed of spindled and epithelioid cells arranged in cords and nests preferentially arrayed around numerous small to medium sized, thin walled vessels with some hyalined thick walls Four cases manifested zone of both dense and sparse cellularity Immunohistochemically, the tumor cells were strongly positive for vimentin, desmin, estrogen receptor and progesterone receptor None of the two cases with follow up of up to 2 years after simple excision developed a recurrence, in contract to AA that exhibited local recurrence in 2 of 5 cases Ultrastructurally, AMFB tumor cells contained some microfilaments and dense bodies Intercellular junctions were apparent Intercellular spaces contained a great of collagen fibers AA showed more indented nuclear, dense myxoid background and thick walled vessels Myoid bundles tended to be located adjacent to blood vessels in all cases Conclusion These results indicate that conventional morphologic analysis is paramount in the recognition of AMFB AMFB and AA shows different clinicopathologic entity and proposes an origin from a perivascular stem cel1 that is capable of myofibroblastic differentiation
出处
《临床与实验病理学杂志》
CAS
CSCD
2000年第1期15-18,共4页
Chinese Journal of Clinical and Experimental Pathology
关键词
血管肌
纤维母细胞瘤
血管粘液瘤
病理学
AMFB
angiomyofibrob1astoma , aggressive angiomyxoma
immunohistochemistry
ultrastructure
