淋巴结内栅栏状肌纤维母细胞瘤临床病理观察
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摘要
目的探讨淋巴结内栅栏状肌纤维母细胞瘤的临床病理特点。方法观察1例腹股沟淋巴结内栅栏状肌纤维母细胞瘤的组织学及免疫表型,并复习相关文献。结果患者女性,51岁。左侧腹股沟无痛性包块4个月。镜下肿瘤由分化成熟的梭形瘤细胞呈栅栏状排列,伴石棉样纤维及肿瘤实质出血、裂隙状血管腔形成。免疫组化:瘤细胞vimentin、SMA、actin和cyclin D1(+),desmin、S-100、Syn、CD117、CD99、HMB45、melan-A、bcl-2、Factor-Ⅷ、CD34、EMA和AE1/AE3(-),Ki-67增殖指数2%。结论淋巴结内栅栏状肌纤维母细胞瘤是原发于淋巴结内罕见的良性间叶性肿瘤,结合影像学、病理学特征及免疫组化可确诊,预后良好。
Objective To explore the clinicopathologic features of intranodal palisaded myofiborblastoma( IPM). Methods The histological and immunological phenotype in a case of IPM was studied and the related literatures were reviewed. Results A 51-year-old woman presented with 4 months history of a painless nodule in the left inguinal region. Microscopically,the lesion was composed of bland looking spindle cells with area of nuclear palisading,amianthoid fibres and areas of fresh as well as old hemorrhages. The spindle cells showed positive staining of vimentin,SMA and actin, cyclin D1,but negative for desmin,S-100,Syn,CD117,CD99,HMB45,melan-A,bcl-2,factor-Ⅷ,CD34,EMA and AE1 / AE3,and low expression of Ki-67 was noted. Conclusion IPM,which possesses a good prognosis,is a rare benign mesenchymal tumor in lymph nodes. It can be diagnosed through imaging, clinicopathologic features and immunological phenotype.
Objective To explore the clinicopathologic features of intranodal palisaded myofiborblastoma( IPM). Methods The histological and immunological phenotype in a case of IPM was studied and the related literatures were reviewed. Results A 51-year-old woman presented with 4 months history of a painless nodule in the left inguinal region. Microscopically,the lesion was composed of bland looking spindle cells with area of nuclear palisading,amianthoid fibres and areas of fresh as well as old hemorrhages. The spindle cells showed positive staining of vimentin,SMA and actin, cyclin D1,but negative for desmin,S-100,Syn,CD117,CD99,HMB45,melan-A,bcl-2,factor-Ⅷ,CD34,EMA and AE1 / AE3,and low expression of Ki-67 was noted. Conclusion IPM,which possesses a good prognosis,is a rare benign mesenchymal tumor in lymph nodes. It can be diagnosed through imaging, clinicopathologic features and immunological phenotype.
引文
[1]Lioe TF,Allen DC,Bell JC.A case of multicentric intranodal palisaded myofibroblastoma[J].Histopathology,1994,24(2):173-175.
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[5]Suster S,Rosai J.Intranodal hemorrhagic spindle-cell tumor with“amianthoid”fibers.Report of six cases of a distinctive mesenchymal neoplasm of the inguinal region that simulates Kaposi’s sarcoma[J].Am J Surg Pathol,1989,13(5):347-357.
[6]Lee JY,Abell E,Shevechik GJ.Solitary spindle cell tumor with myoid differentiation of the lymph node[J].Arch Pathol Lab Med,1989,113(5):547-550.
[7]Nguyen T,Eltorky MA.Intranodal palisaded myofibroblastoma[J].Arch Pathol Lab Med,2007,131(2):306-310.
[8]Cosenza UM,Galati G,Zofrea P,et al.Clinical and biological features of an intranodal palisaded myofibroblastoma[J].Anticancer Res,2006,26(3B):2349-2352.
[9]Fletcher CD,Stirling RW.Intranodal myofibroblastoma presenting in the submandibular region:evidence of a broader clinical and histological spectrum[J].Histopathology,1990,16(3):287-293.
[10]Michal M,ChlumskáA,Povysilova V.Intranodal“amianthoid”myofibroblastoma.Report of six cases immunohistochemical and electron microscopical study[J].Pathol Res Pract,1992,188(1-2):199-204.
[11]Magro G,Foschini MP,Eusebi V.Palisaded myofibroblastoma of the breast:a tumor closely mimicking schwannoma:report of 2cases[J].Hum Pathol,2013,44(9):1941-1946.
[12]Sagar J,Vargiamidou A,Manikkapurath H.Intranodal palisaded myofibroblastoma originating from retroperitoneum:an unusual origin[J].BMC Clin Pathol,2011,11:7.
[13]Creager AJ,Garwacki CP.Recurrent intranodal palisaded myofibroblastoma with metaplastic bone formation[J].Arch Pathol Lab Med,1999,123(5):433-436.
[14]Perez-Mies B,Campos,AI.Intranodal palisaded myofibrobla stoma[J].Arch Pathol Lab Med,2008,132(8):1224-1225.
[15]Kleist B,Poetsch M,Schmoll J.Intranodal palisaded myofibroblastoma with overexpression of cyclin D1[J].Arch Pathol Lab Med,2003,127(8):1040-1043.
[16]Black JO,Zhai QJ,Varona,OB,et al.Primary schwannoma in a cervical lymph node[J].Head Neck,2010,32(7):964-969.
[2]Deligdish L,Loewenthal M,Friedlaender E.Malignant neurilemoma(schwannoma)in the lymph nodes[J].Int Surg,1968,49(3):226-230.
[3]Katz DR.Neurilemmoma with calcosiderotic nodules[J].Isra J Med Sci,1974,10(9):1156-1157.
[4]Weiss SW,Gnepp DR,Bratthauer GL.Palisaded myofibroblastoma.A benign mesenchymal tumor of lymph node[J].Am J Surg Pathol,1989,13(5):341-346.
[5]Suster S,Rosai J.Intranodal hemorrhagic spindle-cell tumor with“amianthoid”fibers.Report of six cases of a distinctive mesenchymal neoplasm of the inguinal region that simulates Kaposi’s sarcoma[J].Am J Surg Pathol,1989,13(5):347-357.
[6]Lee JY,Abell E,Shevechik GJ.Solitary spindle cell tumor with myoid differentiation of the lymph node[J].Arch Pathol Lab Med,1989,113(5):547-550.
[7]Nguyen T,Eltorky MA.Intranodal palisaded myofibroblastoma[J].Arch Pathol Lab Med,2007,131(2):306-310.
[8]Cosenza UM,Galati G,Zofrea P,et al.Clinical and biological features of an intranodal palisaded myofibroblastoma[J].Anticancer Res,2006,26(3B):2349-2352.
[9]Fletcher CD,Stirling RW.Intranodal myofibroblastoma presenting in the submandibular region:evidence of a broader clinical and histological spectrum[J].Histopathology,1990,16(3):287-293.
[10]Michal M,ChlumskáA,Povysilova V.Intranodal“amianthoid”myofibroblastoma.Report of six cases immunohistochemical and electron microscopical study[J].Pathol Res Pract,1992,188(1-2):199-204.
[11]Magro G,Foschini MP,Eusebi V.Palisaded myofibroblastoma of the breast:a tumor closely mimicking schwannoma:report of 2cases[J].Hum Pathol,2013,44(9):1941-1946.
[12]Sagar J,Vargiamidou A,Manikkapurath H.Intranodal palisaded myofibroblastoma originating from retroperitoneum:an unusual origin[J].BMC Clin Pathol,2011,11:7.
[13]Creager AJ,Garwacki CP.Recurrent intranodal palisaded myofibroblastoma with metaplastic bone formation[J].Arch Pathol Lab Med,1999,123(5):433-436.
[14]Perez-Mies B,Campos,AI.Intranodal palisaded myofibrobla stoma[J].Arch Pathol Lab Med,2008,132(8):1224-1225.
[15]Kleist B,Poetsch M,Schmoll J.Intranodal palisaded myofibroblastoma with overexpression of cyclin D1[J].Arch Pathol Lab Med,2003,127(8):1040-1043.
[16]Black JO,Zhai QJ,Varona,OB,et al.Primary schwannoma in a cervical lymph node[J].Head Neck,2010,32(7):964-969.