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性别	男	年龄	34岁	临床诊断	左鼻腔肿块
一般病史	发现左鼻腔肿块3月余。
标本名称	鼻腔肿块活检
大体所见	不规则组织1块，大小约0.8×0.6×0.6cm，表面可见黑色毛发，切面灰白，半透明，质中等。

图1
图2
图3
图4

图片1、2、3分别为显微镜下低倍、中倍和高倍视野所见。

图4为市一南院外景。

标签：鼻腔肿块

本帖最后由海上明月于 2013-08-18 12:12:37 编辑

0

: 王军臣

Giant cell angiofibroma, a variant of solitary fibrous tumor, of the orbit in a 16-year-old girl.

Demirci H, Shields CL, Eagle RC Jr, Shields JA.

Source

Oncology Service and daggerPathology Department, Wills Eye Institute, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.

Abstract

A 16-year-old girl presented with diplopia and gradual-onset, painless proptosis of the left eye. Orbital CT showed a well-circumscribed, enhancing, extraconal mass in the superior orbit, and the surgical excision was performed. Histopathology was interpreted as capillary hemangioma. Five years later, her symptoms recurred, and she was referred to the Oncology Service, Wills Eye Institute. Repeat orbital MRI showed a well-defined, extraconal mass with loculated areas of enhancement in the left orbit superonasally. Complete surgical excision was performed. Histopathologic examination showed benign, patternless spindle-cell proliferation with prominent intrinsic vascularity and multinucleated giant cells, consistent with giant cell angiofibroma, a variant of solitary fibrous tumor. There was intense immunoreactivity for CD34. After 20 months follow-up, there was no recurrence or development of metastasis. Giant cell angiofibroma, a variant of solitary fibrous tumor, is a rare orbital tumor that presents as a well-circumscribed, enhancing mass and can be found in children.

2: 笑笑之人; jcw62

: 王军臣

jcw62 离线: 帖子：2267; 粉蓝豆：459; 经验：4978; 注册时间：2009-05-23; 加关注 | 发消息

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本帖最后由 jcw62 于 2013-08-04 00:35:41 编辑

病灶位于鼻腔，鳞状上皮下真皮层，肿瘤细胞为梭形或多边形，有异型性，可见明显核仁，间质为纤维组织，血管裂隙内可见少量多核巨细胞，免疫组化：Vimentin、CD34强阳性，KP-1梭形细胞阴性，S100、CD31、 Factor VIII、keratin、desmin、SMA 、HMB45均为阴性，符合巨细胞纤维母细胞瘤（Giant cell fibroblastoma）（ intermediate malignancy ）。主要鉴别诊断：肌周细胞瘤、血管肉瘤、巨细胞血管母细胞瘤、巨细胞血管纤维瘤、纤维组织细胞瘤等。肌周细胞瘤一般无多核巨细胞可以排除；血管肉瘤—
CD31、 Factor VIII均阴性可以排除；巨细胞血管母细胞瘤—可见类似未分化的间叶细胞围绕小血管分布；巨细胞血管纤维瘤—间质可见较多小-中等大小的厚壁血管，KP-1（-）。