Thompson L D, Fanburg-Smith J C, Wenig B M
Department of Endocrine & Otorhinolaryngic-Head & Neck Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000, USA.
Ann Diagn Pathol. 2001 Aug;5(4):191-8. doi: 10.1053/adpa.2001.26969.
Nodular fasciitis (NF), uncommon in the auricular area, is a benign reactive myofibroblastic proliferation that may be mistaken for a neoplastic proliferation. Fifty cases of NF of the auricular region were identified in the files of the Otorhinolaryngic-Head and Neck Tumor Registry of the Armed Forces Institute of Pathology. The patients included 22 females and 28 males, aged 1 to 76 years (mean, 27.4 years). The patients usually presented clinically with a mass lesion (n = 49). Five patients recalled antecedent trauma. The lesions were dermal (n = 28) or subcutaneous (n = 11) in those cases where histologic determination was possible, measuring 1.9 cm on average. The majority of the lesions were circumscribed (n = 38), composed of spindle-shaped to stellate myofibroblasts arranged in a storiform growth pattern, juxtaposed to hypocellular myxoid tissue-culture-like areas with extravasation of erythrocytes. Dense, keloid-like collagen and occasional giant cells were seen (n = 18). Mitotic figures (without atypical forms) were readily identifiable. By immunohistochemical staining, myofibroblasts were reactive with vimentin, actins, and CD68. All patients had surgical excision. Four patients (9.3%) developed local recurrence and were alive and disease free at last follow-up. All patients with follow-up (n = 43) were alive or had died of unrelated causes, without evidence of disease an average 13.4 years after diagnosis. Nodular fasciitis of the auricular area occurs most often in young patients. Because NF is more often dermally situated than extremity NF, it may present with superficial ulceration and/or bleeding. Local recurrence is more frequent because of the difficulty in obtaining complete surgical excision around the ear.
结节性筋膜炎（NF）在耳部区域并不常见，是一种良性反应性肌成纤维细胞增生，可能会被误诊为肿瘤性增生。在武装部队病理研究所耳鼻咽喉 - 头颈肿瘤登记处的档案中，共鉴定出50例耳部区域的NF病例。患者包括22名女性和28名男性，年龄在1至76岁之间（平均27.4岁）。患者临床上通常表现为肿块病变（n = 49）。5名患者回忆起有前驱外伤史。在那些能够进行组织学判定的病例中，病变位于真皮层（n = 28）或皮下层（n = 11），平均大小为1.9厘米。大多数病变边界清晰（n = 38），由梭形至星状的肌成纤维细胞组成，呈席纹状生长模式，与细胞稀少的黏液样组织培养样区域相邻，并伴有红细胞外渗。可见致密的、瘢痕疙瘩样的胶原纤维和偶尔的巨细胞（n = 18）。有丝分裂象（无异常形态）易于识别。通过免疫组化染色，肌成纤维细胞对波形蛋白、肌动蛋白和CD68呈阳性反应。所有患者均接受了手术切除。4例患者（9.3%）出现局部复发，在最后一次随访时仍存活且无疾病。所有接受随访的患者（n = 43）均存活或因无关原因死亡，诊断后平均13.4年无疾病证据。耳部区域的结节性筋膜炎最常发生于年轻患者。由于NF比四肢NF更常位于真皮层，可能会出现浅表溃疡和/或出血。由于在耳部周围难以进行完整的手术切除，局部复发更为常见。
