Abou Jaoude J F, Roula Farah A, Sargi Z, Khairallah S, Fakih C
Department of Orthopedic Surgery, Abou Jaoude Hospital, Jal el Dib, Lebanon.
Chir Main. 2000 Sep;19(4):243-52. doi: 10.1016/s1297-3203(00)73487-1.
Glomus tumor is a well known pathology in hand surgery; in addition to sites in the upper limbs, it can also affect the lower limbs and develop in other parts of the body.
Seven females and four males with glomus tumors underwent surgery between 1990 and 1998 at our hospital. These cases were retrospectively studied, and immunohistochemical staining was carried out for vimentin, factor VIII and CD34.
At the time of diagnosis, the mean age of the patients was 49 years, with a mean follow-up of 18.5 months. Regarding tumor site, there were six digital, one wrist, two neck and two lower limb locations. In this series, familial incidence was observed in two cases, i.e., two sisters with tumor occurrence at the same digital site. Tumor size varied from 0.2 to 5 cm. In agreement with the findings in the literature, the present results showed only a low incidence of locations other than in the upper and lower limbs. Moreover, no multiple locations or degenerative malignancy were observed, both of which are known to be rare. In all cases, the histological aspect of these tumors was typically benign. Immunohistochemical studies of the tumor cells were positive for anti-vimentin antibody in all cases, negative for anti-factor VIII in all cases and irregularly positive for anti-CD34 antibody.
It was not possible to confirm the specificity of the anti-CD34 antibody for glomus tumor in this series. The hypothesis of the endothelial origin of glomus tumor can probably be dismissed in the absence of the expression of anti-factor VIII and anti-CD34 antibodies.
血管球瘤是手外科中一种广为人知的病理类型;除了上肢部位外,它也可累及下肢并在身体其他部位发生。
1990年至1998年间,我院对7例女性和4例男性血管球瘤患者进行了手术。对这些病例进行回顾性研究,并对波形蛋白、因子VIII和CD34进行免疫组化染色。
诊断时患者的平均年龄为49岁,平均随访时间为18.5个月。肿瘤部位方面,有6例位于手指,1例位于腕部,2例位于颈部,2例位于下肢。在本系列中,观察到2例家族性发病,即两姐妹在同一手指部位发生肿瘤。肿瘤大小从0.2厘米至5厘米不等。与文献中的研究结果一致,目前的结果显示上肢和下肢以外部位的发病率较低。此外,未观察到多发部位或退行性恶性变,这两者均已知少见。在所有病例中,这些肿瘤的组织学表现均为典型的良性。对肿瘤细胞的免疫组化研究显示,所有病例中抗波形蛋白抗体均呈阳性,所有病例中抗因子VIII均呈阴性,抗CD34抗体呈不规则阳性。
在本系列中无法证实抗CD34抗体对血管球瘤的特异性。在缺乏抗因子VIII和抗CD34抗体表达的情况下,血管球瘤内皮起源的假说可能不成立。