12例孤立性纤维性肿瘤临床病理分析

摘要

Objective:To analyze the clinical and Pathological features,immunoPhenotyPe and differential diagno-sis,biological behavior and Prognosis of the solitary fibrous tumor( SFT). Methods:To collect the solitary fibrous tumor clinicoPathologic materials and immunohistochemical staining information of 12 cases with litaerature review. Results:The average age of Patients with solitary fibrous tumor in the 12 cases was 40. 2(29-70),it mostly occued in the thoracic cavity,1 case was malignant SFT. Under the microscoPe,the tumor cells were mostly sPindle shaPed cells,with the interPhase of less-cell area and multicellular area,the interval was the thick collagen fiber of scar-a-like hyaline degeneration,the branch-shaPed hemangioPericytoma region was visible. Immune PhenotyPe:The sPindle cell Vimentin,CD34 and CD99 diffuse with strong Positive,showing Bcl-2,SMA,EMA,Desmin,S-100 at different levels. Conclusion:SFT belongs to the tumor with the middle biological behavior,it can relaPse or metastasis. Al-though a minority of SFT has the Pattern of the solid cellular fibrosarcoma,itˊs biological behavior is still a relatively benign . Some histological benign SFT may have recurrence and metastasis 10 years after the oPeration,the Prognosis of〝differentiation of SFT〝 is Poor.%目的：探讨孤立性纤维性肿瘤（ solitary fibrous tumor，SFT）的临床病理特点、免疫表型、鉴别诊断、生物学行为及预后。方法：收集12例孤立性纤维性肿瘤的临床病理资料和免疫组化染色，并结合文献进行分析讨论。结果：12例孤立性纤维性肿瘤平均发病年龄为40.2（29-70）岁，多发生于胸腔、腹腔，其中1例为恶性SFT。镜下肿瘤细胞多为梭形细胞，少细胞区和多细胞区相间，两者间隔以瘢痕样透明变性粗胶原纤，可见分枝状的血管外皮瘤样区。免疫表型：梭形细胞Vimentin、CD34和CD99弥漫强阳性，不同程度表达Bcl-2、SMA、EMA、Desmin、S-100。结论：SFT属于中间生物学行为的肿瘤，可复发或转移。少数SFT虽然具有实体富于细胞纤维肉瘤样模式，但其生物学行为仍然相对良性。一些组织学良性的SFT在术后10年也可复发和转移，“去分化SFT”预后差。