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目的探讨孤立性纤维性肿瘤(SFT)的临床及病理形态特征、诊断和鉴别诊断。方法收集发生于不同部位的18例SFT患者,进行临床、组织学形态和免疫组化染色观察,并复习相关文献。结果 SFT患者临床主要表现为缓慢生长的肿块,全身各个解剖部位皆可发生,发病高峰在40~70岁。镜下由交替分布的细胞丰富区和细胞稀疏区组成,被纤维性间质分隔,胶原纤维丰富,并具有血管外皮瘤样分支状血管。免疫组化:瘤细胞特征性强阳性表达CD34和Bcl-2,Vimentin和CD99也呈阳性表达,不表达CK、S-100和SMA。但是,CD34和Bcl-2并不总是阳性,尤其是在恶性SFT患者。若CD34阴性,Bcl-2一般呈弥漫强阳性表达。结论 SFT是一种在形态学和免疫表型上比较有特征性的肿瘤,需要与其它梭形细胞肿瘤相鉴别。大部分病例完整切除可以治愈,但需要长期随访。
Objective To investigate the clinical and pathological features, diagnosis and differential diagnosis of solitary fibrous tumor (SFT). Methods Eighteen cases of SFT patients were collected from different sites and observed clinically and histologically. Immunohistochemical staining and review of relevant literature. Results The main clinical manifestations of patients with SFT slow growth of the mass, all parts of the body can occur, the peak incidence in 40 to 70 years. Mirrored by the alternating distribution of cell-rich areas and sparse cells, separated by the fibrous stroma, collagen fibers rich, and with vascular endothelial tumor-like branch vessels. Immunohistochemistry: The characteristic of tumor cells strongly expressed CD34 and Bcl-2, Vimentin and CD99 also showed positive expression, CK, S-100 and SMA were not expressed. However, CD34 and Bcl-2 are not always positive, especially in patients with malignant SFT. If CD34 negative, Bcl-2 is generally diffuse strong positive expression. Conclusion SFT is a morphologically and immunophenotypically more characteristic tumor that needs to be differentiated from other spindle cell tumors. Complete resection in most cases can be cured, but requires long-term follow-up.