CAJ | 학술논문

目的：探讨盆腔孤立性纤维瘤的临床和病理特征、诊断和鉴别诊断、治疗以及预后。方法：对1例盆腔孤立性纤维瘤的临床和病理、影像学表现、诊断和鉴别诊断及治疗方式等进行探讨。结果：手术标本肉眼观：肿瘤包膜完整,表面光滑,切面灰白,质嫩；镜下观：主要由梭形细胞组成,肿瘤细胞丰富伴轻度异型,核染色质粗,核分裂像分布不均匀,由细胞致密区和疏松区交替无特定结构排列,灶性区可见坏死,低度恶性,间质血管较丰富,细胞间可见大量胶原纤维；免疫组织化学：CD34+, CD31+,Bcl-2凋亡蛋白±,细胞增殖相关抗原20%+,细胞角蛋白-,钙视网膜蛋白-,CD99抗原-,肌间线蛋白-,p53-, S-100+,平滑肌肌动蛋白-,波形蛋白+,WT-1蛋白-。结论：孤立性纤维性肿瘤无特异性临床表现,诊断主要依据病理形态学特征和特异性标志物的免疫组织化学检测；需与其他梭形细胞瘤鉴别；首选手术治疗,术后需进行密切随访。
목적：탐토분강고립성섬유류적림상화병리특정、진단화감별진단、치료이급예후。방법：대1례분강고립성섬유류적림상화병리、영상학표현、진단화감별진단급치료방식등진행탐토。결과：수술표본육안관：종류포막완정,표면광활,절면회백,질눈；경하관：주요유사형세포조성,종류세포봉부반경도이형,핵염색질조,핵분렬상분포불균균,유세포치밀구화소송구교체무특정결구배렬,조성구가견배사,저도악성,간질혈관교봉부,세포간가견대량효원섬유；면역조직화학：CD34+, CD31+,Bcl-2조망단백±,세포증식상관항원20%+,세포각단백-,개시망막단백-,CD99항원-,기간선단백-,p53-, S-100+,평활기기동단백-,파형단백+,WT-1단백-。결론：고립성섬유성종류무특이성림상표현,진단주요의거병리형태학특정화특이성표지물적면역조직화학검측；수여기타사형세포류감별；수선수술치료,술후수진행밀절수방。
Objective:To investigate the clinical and pathological features,diagnosis and differential diagnosis,treatment and prognosis of pelvic solitary fibrous tumor. Methods:The clinical and pathological features, diagnosis and differential diagnosis, treatment and prognosis of pelvic solitary fibrous tumor in a case were explored. Results:Complete capsule, smooth surface, gray cut-off and soft texture of tumor were observed under naked eye. Under microscopy,the tumor was mainly composed of spindle cells,mild dysplasia, coarse nuclear chromatin and uneven mitosis in tumor cells were detected,the tumor cells were alternatively arranged by hypercellularity and hypocellularity,and the necrosis with low potential malignancy,rich interstitial blood vessels and a large number of collagen fibers were found. The CD34+,CD31 +,B-cell lymphoma 2 ± ,antigen Ki-67 20% +,pan-cytokeratin antibody-,Calretinin-,CD99 -, Desmin-,MC-,p53-,S-100+,smooth muscle actin-,Vimentin+ and protein WT-1- were identified by immunohistochemistry. Conclusions:The solitary fibrous tumor has not specific clinical manifestations, the dignosis of which depends on the pathological features and detection of specific markers by immunohistochemistry. The tumor need to be identified with other spindle cell tumor, treated with operation and followed up after operation.