CAJ | 학술논문

目的：分析孤立性纤维性肿瘤（solitary fibrous tumor,SFT）的临床表现、病理学特点、免疫组织化学表型，并随访，探讨其诊断、鉴别诊断及预后。方法对10例孤立性纤维性肿瘤进行临床资料、病理学特点分析及随访，并进行Vimentin、CD34、Bcl-2、CD99、SMA、β-catenin等免疫组织化学检测。结果10例患者中，男6例，女4例，发病年龄31～78岁，平均53．2岁；4例发生在脏层胸膜，2例发生在壁层胸膜，1例发生在胸壁皮下，1例发生在颈部，1例发生在纵隔，1例发生在背部皮下。镜检肿瘤组织主要由梭形细胞构成，可见程度不同的细胞丰富区及细胞稀疏区，瘤细胞呈短梭形或卵圆形，核分裂像因病变程度而异。其间可见丰富的胶原纤维，可伴玻璃样变性或黏液样变。免疫组化显示Vimentin、CD34、Bcl-2、CD99和β-catenin阳性，SMA灶性或弱阳性。结论孤立性纤维性肿瘤可发生于全身各处，临床病理特征及免疫组化表型有助于诊断及鉴别诊断。其生物学行为与组织学形态、生长方式有关，大部分为良性，一般手术完整切除预后良好；少数有低度恶性、恶性可能，表现为局部复发或转移，术后患者需长期随访。
목적：분석고립성섬유성종류（solitary fibrous tumor,SFT）적림상표현、병이학특점、면역조직화학표형，병수방，탐토기진단、감별진단급예후。방법대10례고립성섬유성종류진행림상자료、병이학특점분석급수방，병진행Vimentin、CD34、Bcl-2、CD99、SMA、β-catenin등면역조직화학검측。결과10례환자중，남6례，녀4례，발병년령31～78세，평균53．2세；4례발생재장층흉막，2례발생재벽층흉막，1례발생재흉벽피하，1례발생재경부，1례발생재종격，1례발생재배부피하。경검종류조직주요유사형세포구성，가견정도불동적세포봉부구급세포희소구，류세포정단사형혹란원형，핵분렬상인병변정도이이。기간가견봉부적효원섬유，가반파리양변성혹점액양변。면역조화현시Vimentin、CD34、Bcl-2、CD99화β-catenin양성，SMA조성혹약양성。결론고립성섬유성종류가발생우전신각처，림상병리특정급면역조화표형유조우진단급감별진단。기생물학행위여조직학형태、생장방식유관，대부분위량성，일반수술완정절제예후량호；소수유저도악성、악성가능，표현위국부복발혹전이，술후환자수장기수방。
Objective To analyze solitary fibrous tumor (solitary fibrous tumor, SFT) ’s clinical manifestations, patholog-ical features, immunohistochemical phenotype, and follow-up, discuss the diagnosis, differential diagnosis and progno-sis. Methods Ten cases of SFT were analyzed by clinical data and follow-pathological characteristics study and im-munohistochemical staining of Vimentin, CD34, Bcl-2, CD99, SMA and β-catenin. Results There were 6 males and 4 females with ranging in age from 31 to 78 years (mean 53.2 years old). SFT in four cases originated from the visceral pleura, two cases from parietal pleura,one from the skin of the chest wall, one from the neck, one from the medi-astinum, one from subcutaneously. Microscopic examination of tumor tissue was mainly composed of spindle cells, dif-ferent levels of visible cells and cell-rich areas of sparse areas, tumor cells were short spindle or oval, mitotic due to the severity varies. During the visible rich collagen fibers, may be associated with hyaline degeneration or myxoid change. Immunohistochemistry revealed the tumor cells expessed Vimentin, CD34, Bcl-2, CD99 and β-catenin, SMA focal or weakly positive. Conclusion SFT may occur in various sites of the body. The clinicopathological features and immunohistochemical profile are helpful to identify SFT. Its biological behavior is consistent with its histological mor-phology and growth the way. If tumor could be removed completely, the patients may have a good prognosis;some have low-grade malignant or malignant behaviour, manifesting as local recurrence or metastasis. Patients need long-term follow-up.