良性纖維組織細胞瘤合併平滑肌瘤 ─病例報告及文獻回顧─

Benign Fibrous Histiocytoma Combined with Leiomyoma -A Case Report & Literature Review-

蕭晨隆(Cheng-Lun Hsiao) ； 溫素瑩(Su-Ying Wen)

《中華皮膚科醫學雜誌》 19卷2期 (2001/06) Pp. 161-168

摘要

本文報告一例61歲女性，於右側臀部出現一直徑約1cm具彈性之棕色結節，臨床上之診斷為良性纖維組織細胞癌。完全切除後，可見腫瘤主要位於真皮層中，分成兩個區域，較淺層之區域邊緣呈不規則狀，界限並不明顯亦無包膜包覆，主要由細長之梭狀細胞散佈於排列成交錯的束狀結構之膠原纖維中所構成，較深層區域呈半圓形，與較淺區域之界限並不明顯，主要由具有豐富的嗜伊紅性細胞質及雪茄狀細胞核之細胞組成，Masson's trichrome染色下，較淺層區域之膠原纖維束呈藍色，較深層區域細胞則呈紅色，較淺層區域診斷為一良性纖維組織細胞瘤，Anti-smooth-muscle-actin染色下，較淺層區域呈陰性反應，較深層區域則呈明顯之陽性反應，較深層區域診斷為一平滑肌瘤，我們整理歷年學者們所提出之良性纖維組織細胞瘤合併平滑肌瘤之病例及對良性纖維組織細胞瘤之致病機轉所提出之理論，並討論與此類病例之關係。

並列摘要

A 61-year-old female had an elastic, brownish, dome-shaped nodule, 1cm in diameter, over right buttock. It was clinically diagnosed as benign fibrous histiocyoma. Total excision was performed. Histopathologically, the lesion was located in dermis and composed of two different portions. The superficial portion showed irregular border without capsule and composed of slender spindle cells scattered within interlacing fascicles of collagen fibers. The deeper portion adhered to the superficial portion and was composed of irregular collections of elongated cells with prominent eosinophilic cytoplasm and cigar-shaped nuclei. Stained with Masson trichrome, collagen fibers of the superficial portion revealed blue and cells of the deeper portion revealed purple red. The superficial portion was diagnosed as benign fibrous histiocytoma. Stained with anti-smooth-muscle-actin, the superficial portion showed negative and the deeper portion showed strong positive. The deeper portion was diagnosed as leiomyoma. We would like to review the literature regarding benign fibrous histiocytoma combined with leiomyoma, the pathogenesis of benign fibrous histiocytoma, and to discuss the relationship of benign fibrous histiocytoma with such rare cases.

並列關鍵字

Benign fibrous histiocytoma ； Ieiomyoma ； Anti-smooth-muscle-actin ； Masson Trichrome ； Histiocyoma with leiomyoma