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- B1913软组织肿瘤
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| 姓 名： | ××× | 性别： | 男 | 年龄： | 36岁 |
| 标本名称： | 软组织肿瘤 | ||||
| 简要病史： | 右大腿根部外侧包块2月余，术中见肌间6Ｘ4cm包块，边界清楚，质中，易剥离。 | ||||
| 肉眼检查： | 椭圆形灰色肿物一个，最大直径6.5cm,切面灰色，有裂隙，质韧 | ||||
标签：大腿 孤立性纤维性肿瘤 SFT
×参考诊断
孤立性纤维性肿瘤
Solitary fibrous tumor(孤立性纤维瘤)
patternless architecture of hypo- and hypercellular areas separated by thick, hyalinized collagen with cracking artifact and hemangiopericytoma-like vessels; bland and uniform spindle cells are dispersed along thin parallel collagen strands, cells have minimal cytoplasm, small elongated nuclei and indistinct nucleoli; some have myxoid change , mast cells, adipose tissue or multinucleated giant cells; minimal pleomorphism; no atypia, no/rare mitotic figures.
malignant SFT - hypercellular, moderate to marked atypia and pleomorphism, tumor cell necrosis, 4+ mitotic figures/10 HPF, infiltrative margins
Positive stains: CD34 (90%), CD99 (60-70%); variable bcl-2, EMA and actin
Negative stains: desmin, keratin, S100, CD117, CD31,vessels are D2-40 negative
Differential diagnosis:
▪ synovial sarcoma - usually no thick collagen bands; keratin+, CD34-
▪ smooth muscle tumors - fascicles of cells with more abundant cytoplasm, blunted nuclei, desmin+, actin+
▪ benign neural tumors - S100+
