摘要
目的探讨非典型梭形细胞/多形性脂肪瘤样肿瘤(ASLT/APLT)临床特征、病理学形态、免疫组化特点及鉴别诊断。方法回顾性分析2例ASCL/APL患者的临床资料并复习国内外相关文献。结果2例患者,其中1例为男性,49岁,肿物位于头皮下,大小为1.5 cm×1.3 cm×1 cm。另1例为女性,72岁,肿物位于大腿,大小为13 cm×11.5 cm×7 cm。2例肿物肉眼均未见包膜。显微镜下:2例肿瘤边界均不清,局灶呈浸润性生长。在纤维及黏液的背景下,肿瘤由不同比例的非典型梭形细胞、脂肪细胞、脂肪母细胞及多核细胞组成。免疫组化:2例梭形细胞均弥漫表达CD34、P16,1例S-100阳性,1例CDK4阳性,2例MDM2均阴性。视网膜母细胞瘤基因蛋白(Rb)1例阴性,1例阳性。Ki-67增殖指数1%~2%。MDM2基因荧光原位杂交检测2例肿瘤均为阴性。2例患者均只做了肿瘤切除,随访至2022-04,均未见复发及转移。结论ASLT/APLT为同一谱系的少见类型的良性肿瘤,细胞形态存在非典型性,易与其他良恶性软组织肿瘤相混淆,鉴别诊断需要结合免疫组化及分子检测。
Objective To investigate the clinical,morphology,immunohistochemical features and differential diagnosis of atypical spindle cell/pleomorphic lipomatous tumor.Methods The clinical data of two patients were analyzed retrospectively and the related literatures were reviewed.Results One patient was male,aged 49 years.The tumor located under the scalp,and the size was 1.5 cm×1.3 cm×1 cm.The other case was female,aged 72 years.The tumor located in the leg,and the size was 13 cm×11.5 cm×7 cm.In both cases,no capsule was seen.Microscopically,the boundaries of the tumors were unclear,and all showed a focally infiltrative front.Both tumors were composed of varying proportions of atypical spindle cells,adipocytes,lipoblasts and multinucleated cells in a background of variable fibrous and edematous matrix.Immunohistochemically,both tumor cells were diffuse expression of CD34 and P16.One case of S100 was positive.One case of CDK4 was positive and both MDM2 were negative.One case of Rb was positive and the other was negative.Ki-67 index was 1-2%。FISH of MDM2 was done in two cases,and both showed no amplification.Conclusion ASLT/APLT is a rare type of benign tumor.The morphology of tumor cells were atypical.It is easily confused with other benign and malignant soft tissue tumors.The differential diagnosis requires a combination of immunohistochemistry and FISH.
作者
任风梅
解建军
杨真
刘芳
李玉军
REN Feng-mei;XIE Jian-jun;YANG Zhen;LIU Fang;LI Yu-jun(Department of Pathology,Qingdao Chengyang People's Hospital,Qingdao 266109,China;Department of Pathology,the Affiliated Hospital of Qingdao University Medical College,Qingdao 266000,China)
出处
《诊断病理学杂志》
2023年第5期455-458,471,共5页
Chinese Journal of Diagnostic Pathology
关键词
脂肪瘤
梭形细胞/多形性
非典型
临床病理特征
免疫组织化学
诊断
Lipomatous
Spindle cell/Pleomorphic,atypical
Clinicopathological features
Immunohistochemistry
Diagnosis
