Fujishima N, Ooya M, Miura G, Yamaguchi M, Moriuti A
Department of Surgery, Oita-Prefectural Mie Hospital, Japan.
Nihon Geka Gakkai Zasshi. 1998 Dec;99(12):865-7.
A 74-year-old man consulted this hospital with the chief complaint of lower right abdominal pain on February 13, 1998. He was hospitalized, subjected to abdominalechography and CT, and diagnosed as having subileus caused by an intraperitoneal tumor. Surgery was performed on February 25, 1998. When the abdomen was incised, a chicken egg-sized tumor at the end of theappendix were found. In addition, the stalk of the appendix was twisted. Appendectomy was therefore performed. Upon histopathological examination, it was found that the submucosal tumor originated at the end of the appendix, and proliferation of spindle-shaped fibroblast-like cells and histocytic oval cells was observed in the tumor. Since various histiocyte markers were positive upon immunohistological examination, the tumor was considered to be of histiocytic origin. However, the tumordid not exhibit polymorphism, heteromorphism, or mitotic figures which would confirm a diagnosis of malignant fibrous histiocytoma. It was thus diagnosed as a fibrous histiocytic tumor on the borderline between malignant and benign. We report the present case because the occurrence of a primary fibrous histiocytoma in an appendix of which the stalk is twisted is very rare.
一名74岁男性于1998年2月13日因右下腹痛为主诉前来本院就诊。他住院后接受了腹部超声检查和CT检查，被诊断为腹膜内肿瘤引起的不全肠梗阻。1998年2月25日进行了手术。打开腹腔后，发现阑尾末端有一个鸡蛋大小的肿瘤。此外，阑尾的根部发生了扭转。因此进行了阑尾切除术。组织病理学检查发现，黏膜下肿瘤起源于阑尾末端，肿瘤内可见梭形成纤维细胞样细胞和组织细胞样椭圆形细胞增生。免疫组织学检查显示各种组织细胞标志物呈阳性，因此该肿瘤被认为起源于组织细胞。然而，该肿瘤未表现出多形性、异型性或有丝分裂象，这些特征可确诊为恶性纤维组织细胞瘤。因此，它被诊断为介于恶性和良性之间的纤维组织细胞瘤。我们报告该病例是因为阑尾原发性纤维组织细胞瘤伴根部扭转的情况非常罕见。
