| 摘要: |
| 目的 探讨非典型纤维黄色瘤（AFX）的临床病理特征及鉴别诊断。方法 收集南昌大学第二附属医院2016年1月至2021年12月诊治的5例AFX患者资料，回顾性分析AFX的流行病学特点、病理学形态及免疫组织化学特征。结果 5例AFX患者中男3例、女2例，平均年龄为58.6岁。AFX表现为皮肤浅表结节，最大径0.9～ 2.5 cm。镜下肿瘤细胞形态多样，以梭形细胞及上皮样细胞为主，混有单核及多核瘤巨细胞，核分裂象易见。其中1例瘤细胞质内含有色素，1例合并基底细胞癌，1例伴大量炎症细胞。免疫组织化学标志物显示AFX以表达波形蛋白、CD10为主，部分病例表达细胞角蛋白、上皮细胞膜抗原及CD68，所有病例Ki-67增殖指数均较高。5例AFX患者均行皮肤肿块局部切除，仅1例术后行放射治疗，随访至2022年5月5例患者均无复发及转移。结论 AFX临床罕见，镜下改变易与恶性肿瘤混淆，包括CD10在内的免疫组织化学指标有助于其诊断与鉴别诊断。 |
| 关键词: 非典型纤维黄色瘤 病理学特征 免疫组织化学 鉴别诊断 治疗 |
| DOI：10.16781/j.CN31-2187/R.20220409 |
| 投稿时间：2022-05-13修订日期：2022-11-14 |
| 基金项目: |
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| Atypical fibroxanthoma: a clinicopathologic analysis of 5 cases |
| SU Xiao-yan,TAO Xin,LIAO Shou-sheng,YANG Gao-liang,LIN Lan,ZENG Lei* |
(Department of Pathology, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China
*Corresponding author) |
| Abstract: |
| Objective To investigate the clinicopathologic features and differential diagnosis of atypical fibroxanthoma (AFX). Methods A total of 5 AFX cases were collected from Jan. 2016 to Dec. 2021 in The Second Affiliated Hospital of Nanchang University. The epidemiological characteristics, pathological morphology and immunohistochemical characteristics were analyzed retrospectively. Results Among the 5 AFX patients, there were 3 males and 2 females, with an average age of 58.6 years. AFX showed superficial skin nodules with a maximum diameter of 0.9-2.5 cm. Microscopically, the morphology of the tumor cells varied largely, mainly characterized by spindle cells and epithelioid cells, mixed with mononuclear and multinucleated tumor giant cells, and mitotic images were easy to see. Among them, 1 case contained pigment, 1 case combined with basal cell carcinoma, and 1 case had many inflammatory cells. Immunohistochemical markers showed that AFX mainly expressed vimentin and CD10; cytokeratin, epithelial membrane antigen and CD68 were expressed in some cases; and Ki-67 proliferation index was high in all patients. Local resection of skin mass was performed in all the 5 cases, and postoperative radiotherapy was performed in only 1 case. There were no local recurrence or metastasis during follow-up until May 2022. Conclusion AFX is rare in clinic and can easily be confused with malignant tumors under microscope. Immunohistochemistry indexes including CD10 are helpful for its diagnosis and differential diagnosis. |
| Key words: atypical fibroxanthoma pathological features immunohistochemistry differential diagnosis treatment |
