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腹腔炎性肌纤维母细胞瘤的临床病理分析

Clinicopathologic Features and Surgical Treatment of Abdominal Inflammatory Myofibroblastic Tumor

  • 摘要:
    目的  分析腹腔炎性肌纤维母细胞瘤(IMT)的临床病理特点、诊疗方法及预后。
    方法  回顾性分析经手术治疗的13例腹腔炎性肌纤维母细胞瘤患者的临床病理资料。
    结果  本组患者女8例、男5例,中位年龄24岁(15~57岁)。临床表现为腹部肿物、腹部不适隐痛、发热、体重减轻等非特异性症状,影像学检查无明显特异性。SMA、MSA、Vim免疫组织化学检查均为阳性。本组患者均接受手术治疗,术后随访31~76月(中位44月),1例术后13月复发,再次手术后无复发,其余12例无复发和转移。
    结论  腹腔IMT缺乏典型临床及影像学表现,明确诊断依靠病理检查,SMA、MSA、Vim多为阳性,有助于IMT的诊断,手术切除是首选治疗方法,预后良好。

     

    Abstract:
    Objective  To investigate the clinicopathologic features, diagnosis and surgical treatment of inflammatory myofibroblastic tumor (IMT).
    Methods  A retrospective clinical analysis was made in 13 cases of IMT confirmed pathologically and admitted from January 2008 to December 2012 in the Cancer Hospital Chinese Academy of Medical Sciences.
    Results  Eight females and five males with a median age of 24 years (range: 15-57 years) were enrolled. The clinical presentation of IMT was non-specific and insufficient to establish a diagnosis. The patients in this series presented with a palpable abdominal mass, abdominal discomfort, fever, and weight loss. Surgical treatment was performed on all patients. The immunohistochemical analyses revealed that the positive incidences for SMA, MSA, and Vim were 100% (13/13), 100% (13/13), and 100% (13/13) respectively. During the follow-up period of 31-76 months (median: 44 months), one patient underwent reoperation for recurrence 13 months after the first operation, and the other 12 patients showed no metastasis or recurrence.
    Conclusion  Abdominal IMT is rare and with no specific clinical manifestation. The diagnosis of IMT remains difficult and mainly relies on pathological findings. SMA, MSA, and Vim are helpful in the diagnostic process. Surgical resection is the optimal treatment for tumors suspected of IMT, and the prognosis is favorable.

     

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