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目的探讨特殊类型炎症性肌纤维母细胞肿瘤(IMFT)的临床病理特点和鉴别诊断。方法分析4例特殊类型IMFT的临床病理和超微结构并进行免疫组化CK、SMA、结蛋白、CD31、CD34、S-100和ALK等检测。结果4例IMFT中男性1例,女性3例,年龄14~65岁;肿块位于膀胱、大腿、足趾及髌骨,1例为多灶性。肿瘤无包膜,肿瘤细胞梭形,呈束状、编织状排列,细胞质丰富,背景为大量炎症细胞;其中3例出现片状坏死和出血,1例出现肿瘤血管内凸入,1例细胞异型较明显,核分裂象5个/10HPF。肿瘤细胞vimentin和SMA均(+),2例CK(+),而CD31、CD34、S-100和ALK均(-)。电镜示梭形细胞有肌丝及致密体、吞饮小泡及不完整的基膜。结论炎症性肌纤维母细胞肿瘤是由梭形细胞和炎症细胞组成的肿瘤,需与其他梭形细胞肌纤维母细胞肉瘤鉴别。
Objective To investigate the clinicopathological features and differential diagnosis of special type of inflammatory myofibroblastic tumor (IMFT). Methods The clinicopathological and ultrastructural changes of 4 cases of special type IMFT were analyzed and the expressions of CK, SMA, desmin, CD31, CD34, S-100 and ALK were detected by immunohistochemistry. Results Among the 4 cases, 1 was male and 3 was female. The age ranged from 14 to 65 years. The lumps were located in the bladder, thigh, toe and patella, and 1 was multifocal. The tumors were non-enveloped, the tumor cells were fusiform, arranged in a bundle, weaved, and cytoplasm rich with a large number of inflammatory cells in the background. Three cases had lamellar necrosis and hemorrhage. One case had tumor vascular protrusion and one case was abnormal More obvious, mitotic figures like 5 / 10HPF. The tumor cells vimentin and SMA were (+), 2 cases of CK (+), while CD31, CD34, S-100 and ALK were (-). Electron microscopy Fusiform cells with myofilaments and dense body, swallow drink vesicles and incomplete basement membrane. Conclusions Inflammatory myofibroblastic tumor is a tumor composed of spindle cells and inflammatory cells, and needs to be differentiated from other spindle cell myofibroblastic sarcomas.