%0 Journal Article
%T 女性下生殖道浅表肌纤维母细胞瘤9例临床病理分析
%A 胡美香　丁莉　林东亮　赵涵　赵鹏　邢晓明
%J -
%D 2020
%R 10.13362/j.jpmed.202001006
%X 摘要 目的　探讨女性下生殖道浅表肌纤维母细胞瘤（SMFGT）的临床病理特征、免疫表型特点及鉴别诊断要点。 方法　对青岛大学附属医院病理科2017年1月—2019年9月共356例诊断为阴道、宫颈及外阴良性息肉及结节状病变的病理切片进行重新评估。对筛选出的9例SMFGT病人的临床信息进行总结，同时对肿瘤重新进行组织形态学观察及免疫组织化学染色。免疫组织化学染色抗体包括雌激素受体（ER）、孕激素受体（PR）、结蛋白、CD34、S100蛋白、P16、P53及ki67。同时对病人进行电话随访。 结果　病人年龄34～57岁，中位年龄45岁；肿瘤大小0.7～2.0 cm，中位最大直径1.2 cm；8例位于阴道，1例位于子宫颈；4例病人表现为阴道流血，2例病人表现为阴道流液，另外3例病人无临床症状。肉眼下肿瘤均呈息肉样。镜下肿瘤位于黏膜下,大部分病例浅表或肿瘤周边区域瘤细胞相对稀疏，中央区域瘤细胞相对较丰富，肿瘤细胞呈梭形，细胞排列方式多样。肿瘤细胞无明显异型性,核分裂象罕见。9例肿瘤细胞表达ER、PR及结蛋白；9例肿瘤细胞表达CD34；均不表达S100蛋白、P16及P53。 结论　SMFGT是一种发生于女性下生殖道的良性间叶性肿瘤，形态及免疫表型与其他一些发生于女性生殖道的肿瘤有一定相似性，病理医生需掌握其组织学及免疫组织化学特点，从而做出明确诊断。<br>Abstract：Objective　To investigate the clinicopathological and immunohistochemical features of superficial myofibroblastoma of the lower female genital tract (SMFGT) and the key points in the differential diagnosis of this disease. Methods　The pathological sections of 356 patients who were diagnosed with vaginal, cervical or valval benign polypus or nodular lesion in Department of Pathology, The Affiliated Hospital of Qingdao University, from January 2017 to September 2019 were reevaluated. The clinical data of 9 patients with SMFGT were summarized, and the tumors were reevaluated by histomorphological observation and immunohistochemical staining. The antibodies for immunohistochemical staining included estrogen receptor (ER), progesterone receptor (PR), desmin, CD34, S100 protein, P16, P53, and ki67. The patients were also followed up by telephone. Results　The patients had an age of 34-57 years (with a median age of 45 years) and a tumor size of 0.7-2.0 cm (median 1.2 cm). Of all 9 patients,8 had tumor located in the vagina and 1 had tumor located in the cervix; as for clinical symptoms,4 had vaginal bleeding,2 had vaginal discharge, and 3 had no clinical symptoms. Gross examination showed that the tumor was polypoid. Microscopic observation showed that the tumor was located under the mucosa, and most patients had superficial tumor or relatively sparse tumor cells around the tumor, with relatively abundant tumor cells in the central area; the tumor cells were spindle-shaped and had various arrangement patterns. The tumor cells had no obvious atypia, and mitotic figures were rare. The tumor cells were positive for ER (9/9), PR (9/9), desmin (9/9), and CD34 (5/9), but negative for S100 protein, P16, and P53. Conclusion　SMFGT is a benign mesenchymal tumor that occurs in the lower female genital tract. It has similar morphology and immunophenotype as some other tumors in the female genital tract, and pathologists should grasp the histological and immunohistochemical features of SMFGT so
%K 阴道肿瘤
%K 宫颈肿瘤
%K 外阴肿瘤
%K 肿瘤
%K 肌组织
%K 肌纤维母细胞瘤
%K 病理学
%K 组织学
%K 免疫组织化学
%K 诊断
%K 鉴别<br>Vaginal neoplasms
%K Uterine cervical neoplasms
%K Vulvar neoplasms
%K Neoplasms
%K muscle tissue
%K Superficial myofibroblastoma
%K Pathology
%K Histology
%K Immunohistochemistry
%K Diagnosis
%K differential
%U http://jpmed.qdu.edu.cn/CN/10.13362/j.jpmed.202001006