Clinical and Pathological Characteristics of Extrapleural Solitary Fibrous Tumor
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摘要:
目的 探讨胸膜外孤立性纤维性肿瘤的临床病理特征及鉴别诊断。 方法 对26例胸膜外孤立性纤维性肿瘤样本进行HE及免疫组织化学染色，并结合临床及影像学资料进行综合分析。 结果 孤立性纤维性肿瘤的组织学形态多样，典型者可见卵圆形或梭形细胞不规则排列，间质中可见粗大的胶原带、鹿角状血管及管周透明变性；免疫组化染色STAT-6、CD34、Bcl-2、CD99、SMA阳性率分别为96.2%、92.3%、92.3%、76.9%、26.9%。 结论 SFT常见发生于胸膜，亦可发生于其它部位，其组织学特征和免疫组化表型有助于明确诊断，但当其发生于不常见的解剖部位时，应当对重点需要鉴别或排除的疾病加以认真细致的鉴别并综合判断其临床预后。 -
关键词:
- 胸膜外孤立性纤维性肿瘤 /
- 组织学形态 /
- 生物学行为 /
- 临床预后
Abstract:Objective To investigate the clinical and pathological characteristics of the extrapleural solitary fibrous tumor and the relevant differential diagnosis. Methods HE and immunohistochemical staining were performed on 26 samples of isolated fibrous tumors outside the pleura, and a comprehensive analysis was conducted based on the clinical and imaging data. Results The histological morphology of isolated fibrous tumors was diverse, with typical cases showing the irregular arrangement of oval or spindle shaped cells. In the stroma, thick collagen bands, antler like blood vessels, and peritubular transparent degeneration could be seen. The immunohistochemical staining demonstrated that the positive rates of STAT-6、CD34、Bcl-2、CD99、SMA were 96.2%、92.3%、92.3%、76.9% and 26.9%, respectively. Conclusion SFT commonly occurs in the pleura and can also occur in other areas. Its histological characteristics and immunohistochemical phenotype help to clarify the diagnosis. However, when it occurs in uncommon anatomical sites, it is necessary to carefully and meticulously distinguish and comprehensively judge the clinical prognosis of key diseases that need to be distinguished or excluded.. -
图 1 胸膜外孤立性纤维性肿瘤的HE染色（10×/20×）
A：疏松排列的梭形肿瘤细胞；B：密集排列的卵圆形肿瘤细胞；C：“鹿角”状血管及间质黏液变性；D-F分别为A-C在20倍物镜下的形态学图片。
Figure 1. HE staining of ESFT （10×/20×）
表 1 病例基本情况
Table 1. Basic information of patients
性别 n 年龄（岁） 肿瘤大小（cm） 男 15 >55（n = 6） >5（n = 14） 女 11 ≤55（n = 20） ≤5（n = 12） 
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表 2 胸膜外孤立性纤维性肿瘤的病理学特征
Table 2. Pathological characteristics of ESFT
病理特征 n 占比（%） 组织学形态 “鹿角状”薄壁血管 13 50.0 血管周透明变性 6 23.1 细胞丰富、有异型性 1 3.8 小灶坏死 1 3.8 间质黏液变性 6 23.1 微囊性变 3 11.5 小出血灶 3 11.5 成熟脂肪细胞 2 7.7 淋巴细胞浸润 2 7.7 免疫表型 STAT-6 25 96.2 CD34 24 92.3 Bcl-2 24 92.3 Vimentin 26 100.0 CD99 20 76.9 SMA 7 26.9 S-100 6 23.1 EMA 13 50.0 Desmin 1 3.8 CD117 0 0
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