美国外科病理学杂志 | 女性梭形细胞脂肪瘤

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  摘要
  典型的梭形细胞脂肪瘤(spindle cell lipomas,SCL)约80%~90%发生于男性的颈背部(披肩区)。根据这些临床特点,女性患者诊断SCL常常要更为谨慎。我们猜想,发生于女性的SCL有更加多变的表现。在过去的11年中,本单位共诊断了395例SCL,对其中发生于女性患者需要重新审查进行诊断。免疫组织化学检测主要包括CD34,结蛋白, 雌激素受体(estrogen receptor,ER)和p16。对一部分病例行荧光原位杂交技术(fluorescence in situ hybridization,FISH)检测视网膜母细胞瘤1(retinoblastoma 1,RB1)基因缺失。在395例SCL中,331例(86%)为男性;53例为女性(14%)(11例经回顾分析后被排除出组)。原诊断为SCL的64例女性中,58例有住院资料,其中53例最终确认为SCL。与男性患者相比(中位年龄64岁,范围23~98岁),女性患者在诊断时更年轻(中位年龄51岁,范围5~76岁)(P<0.0001,t检验)。女性患者SCL多发生于颈背部(披肩区)以外区域,占总数68%(53例患者中的36例),而男性发生颈背部以外区域者仅为29%(331例患者中有95例)(P<0.001);这些区域包括肢端(女性53例中有16例,占比30%;男性331例中有32例,占比10%)和面部(女性53例中有11例,占比21%;男性331例中有47例,占比14%)。女性患者中发生于皮肤者也较为常见(53例中有16例,占比30%)。肿瘤组织学呈不同比例混合形态的温和梭形细胞、陈旧性胶原、粘液样基质和脂肪细胞。免疫组织化学结果显示,肿瘤46例全部表达CD34+,48例全部结蛋白阴性,42例中33例ER阴性,以及42例中29例p16表达缺失。FISH检测结果显示,14例中12例RB1基因缺失。发生于女性的SCL常位于不典型部位,并且患者更为年轻。
  来源:Am J Surg Pathol 2017;41:1267–1274
  美国外科病理学杂志中文版2017年第一期摘要No.2
  (张静渊 翻译;饶秋 审校)
  The American Journal of Surgical Pathology中文版声明:
  2017 American Journal of Surgical Pathology and Wolters Kluwer Health
  The material is published by Wolters Kluwer Health with the permission of American Journal of Surgical Pathology.No
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