肺部实性型血管瘤样纤维组织细胞瘤2例并文献复习
摘要
目的探讨实性型血管瘤样纤维组织细胞瘤(angiomatoid fibrous histiocytoma,AFH)的临床病理特点、免疫表型、分子遗传学改变、诊断及鉴别诊断。方法回顾性分析2例实性型AFH的临床病理学特点、免疫表型等,并复习相关文献。采用荧光原位杂交(fluorescence in situ hybridization,FISH)技术检测EWSR1基因融合情况。结果 2例患者男女各1例,年龄分别为55、65岁,临床除偶尔干咳外,无其他明显症状。患者均为CT检查时偶然发现,肿瘤分别位于右肺中叶及右肺下叶。眼观:肿瘤最大径为0. 8、1. 5 cm,境界清楚,切面灰白色、灰黄色或灰红色,质实。镜检:瘤细胞呈组织细胞样,实性片状排列,均有较厚的纤维性假包膜及周围淋巴细胞、浆细胞浸润。免疫表型:2例均表达vimentin、CD99、EMA、CD68,均不表达S-100蛋白、CKpan、CD34、CD31、SMA、CD35、CD21、CD30。2例均部分表达desmin。FISH检测EWSR1呈阳性。结论实性型AFH是AFH的亚型之一,属于交界性病变,其诊断主要依靠病理学形态,结合免疫表型和EWSR1基因检测有助于诊断及鉴别诊断。
引文
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[7]焦南林,卢林明,张帆,等.血管瘤样纤维组织细胞瘤的临床病理观察[J].皖南医学院学报,2015,34(5):437-439.
[8]吴露,武世伍,柴大敏,等.血管瘤样纤维组织细胞瘤3例临床病理分析[J].临床与实验病理学杂志,2018,34(2):207-209.
[9] Ghigna M R,Hamdi S,Petitpretz P,et al. Angiomatoid fibrous histiocytoma of the pulmonary artery:a multidisciplinary discussion[J]. Histopathology,2014,65(2):278-282.
[10] Bohman S L,Goldblum J R,Rubin B P,et al. Angiomatoid fibrous histiocytoma:an expansion of the clinical and histological spectrum[J]. Pathology,2014,46(3):199-204.
[11]郭琦,余英豪,曲利娟.肺部血管瘤样纤维组织细胞瘤1例并文献复习[J].临床与实验病理学杂志,2014,30(1):67-68.
[12] Wilk M,Zelger B G,Debiec-Rychter M,et al. Angiomatoid fibrous histiocytoma case series with emphasis on a late fibrotic variant[J]. Dtsch Dermatol Ges,2015,13(5):441-448.
[2]王正,范钦和,王坚,等.实性型血管瘤样纤维组织细胞瘤临床病理观察[J].中华病理学杂志,2013,42(11):744-747.
[3] Shi H,Li H,Zhen T,et al. clinicopathological features of angiomatoid fibrous histiocytoma:a series of 21 cases with variant morphology[J]. Int J Clin Exp pathol,2015,8(1):772-778.
[4] Mengoli M C,Longo F R,Fraggetta F,et al. The 2015 World Health Organization classification of lung tumors:new entities since the 2004 classification[J]. Pathologica,2018,110(1):39-67.
[5]武彤彤,胡维维,杨清绪,等.血管瘤样纤维组织细胞瘤6例临床病例分析[J].临床与实验病理学杂志,2013,29(7):761-764.
[6] Saito K,Kobayashi E,Yoshida A,et al. Angiomatoid fibrous histiocytoma:a series of seven cases including genetically confirmed aggressive cases and a literature review[J]. BMC Musculoskeletal Disord,2017,18(1):31.
[7]焦南林,卢林明,张帆,等.血管瘤样纤维组织细胞瘤的临床病理观察[J].皖南医学院学报,2015,34(5):437-439.
[8]吴露,武世伍,柴大敏,等.血管瘤样纤维组织细胞瘤3例临床病理分析[J].临床与实验病理学杂志,2018,34(2):207-209.
[9] Ghigna M R,Hamdi S,Petitpretz P,et al. Angiomatoid fibrous histiocytoma of the pulmonary artery:a multidisciplinary discussion[J]. Histopathology,2014,65(2):278-282.
[10] Bohman S L,Goldblum J R,Rubin B P,et al. Angiomatoid fibrous histiocytoma:an expansion of the clinical and histological spectrum[J]. Pathology,2014,46(3):199-204.
[11]郭琦,余英豪,曲利娟.肺部血管瘤样纤维组织细胞瘤1例并文献复习[J].临床与实验病理学杂志,2014,30(1):67-68.
[12] Wilk M,Zelger B G,Debiec-Rychter M,et al. Angiomatoid fibrous histiocytoma case series with emphasis on a late fibrotic variant[J]. Dtsch Dermatol Ges,2015,13(5):441-448.