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姓 名: | ××× | 性别: | 男 | 年龄: | 36岁 |
标本名称: | 右第四趾包块 | ||||
简要病史: | 右第四趾无痛性包块10年,逐渐增大。骨组织无破坏。 | ||||
肉眼检查: | 灰白组织一块7*4*4cm,包裹第四趾骨,切面灰白色,质地中等,有粘液感。 |
发生在指趾,细胞无异型性,我感觉像是表浅肢端纤维粘液瘤(superficial acral fibromyxoma),此瘤2001年首次报道,粘液背景中富于血管。此瘤需要和以下良性肿瘤鉴别:
The differential diagnosis of SAFM encompasses benign or malignant myxoid and
spindle cells tumors showing predilection for distal extremities. Myxoid
neurofibroma is one of the main differential diagnoses as tumor cells in SAFM
often have a neural-like appearance. However, neurofibroma is consistently
positive for S100 protein and does not show the increased vasculature of SAFM.3
Immunostaining for CD34 is not diagnostically helpful as this marker is often
focally positive in neurofibroma. Sclerosing perineurioma, a recently described
tumor of the fingers and palms, is composed of spindled and epithelioid EMA
positive cells arranged in an onion-skin pattern. Although CD34 is expressed in
some perineuriomas, it is usually negative in sclerosing perineurioma.4-6
Superficial angiomyxoma shows a predilection for the head and neck area but can
be encountered in virtually any location. The lesion shows a distinctive
lobulated pattern and is usually poorly demarcated. It is composed of bland
spindle-shaped or stellate cells and neutrophils are characteristically found
within the myxoid matrix. An epithelial component is seen in about one third of
cases.
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