长骨炎症性肌纤维母细胞性肿瘤的临床病理观察

摘要

Purpose To study the clinicopathologic features of inflammatory myofibroblastic tumor (IMT) of long bone.Methods HE and immunohistochemistry of EnVision two-step were used to observe the clinical,radiological,histological and immunophenotype features of IMT of bone.The literatures were reviewed.Results 4 cases of IMT of bone were respectively located in the tibia (2 cases) and femur (2 cases).Histologically,the lesions were characterized by collagen-rich and spindled to plump myofibroblast-like cells and a variable admixture of inflammatory cells.Immunohistochemical study showed that the vimentin,SMA,actin,H-caldesmon and CD34 were positive.Conclusion The IMT is a rare and locally aggressive tumor.The diagnosis should combine the histological characters with immunohistochemical results and should be differentiated from the other tumors and tumor-like lesions.%目的 探讨骨内炎症性肌纤维母细胞性肿瘤(inflammatory myofibroblastic tumor,IMT)的临床病理特征、免疫表型、诊断及鉴别诊断.方法 采用HE、免疫组化EnVision两步法染色对4例骨内IMT的临床病理学特征进行分析并复习相关文献.结果 4例IMT中女性1例,男性3例,发生于胫骨、股骨各2例,其中3例同时累及骨及软组织.组织学上由肌纤维母细胞样梭形细胞增生伴浆细胞、淋巴细胞、嗜酸性粒细胞等炎细胞浸润.免疫表型:vimentin、SMA、actin、H-caldesmon、CD34均呈阳性,部分细胞表达CD68.结论 IMT是具有局部侵袭性的交界性肿瘤,临床较罕见,应与一些良性及恶性的软组织肿瘤及肿瘤样病变鉴别.