Tan Guang-ming, Wen Ping
Department of Pathology, Ohio State University Medical Center, Columbus, OH 43210, USA.
Zhonghua Bing Li Xue Za Zhi. 2003 Oct;32(5):404-8.
To study the clinicopathologic features of dendritic fibromyxolipoma for the purpose of differentiating it from other confusable soft tissue neoplasms.
Eight cases of dendritic fibromyxolipoma were obtained and their clinicopathologic features were studied. Immunohistochemistry stains for CD34, bcl-2, vimentin, cytokeratin, EMA, S-100, HHF35 and smooth muscle actin were performed with labeled streptavidin-biotin (SLAB) system on DAKO auto-immunohistochemical stainer.
Dendritic fibromyxolipoma usually occurrs in middle-aged to elderly men, developing primarily in the subcutis or muscular fascia of the head and neck region, shoulder, back, calf and foot. Grossly, it is well-circumscribed, partly thinly encapsulated lesion with focal mucinous or gelatinous cutting surface. Histologically, all these tumors showed similar histological features., and were characterized by an admixture of mature adipose tissue, spindle and stellate cells, and abundant myxoid stroma with prominent collagenization. The proportion of above elements varied in different tumors or in different areas within the same tumor. One of the pathologic characteristics was the proliferation of spindle cells and stellate cells showing thin cytoplasmic dendritic prolongations. No cytological atypia or mitotic activity could be identified. Furthermore, the lesions were well-vascularized and the vascular elements consisted of small to median-sized and capillary-sized plexiform vessels. Spindle cells were strongly positive for CD34, bcl-2 and vimentin but negative for S-100 protein and epithelial and muscle markers.
Dendritic fibromyxolipoma is characterized by clinicopathologic and immunohistochemical features. Based on those features of this tumor, this entity appears to represent a transitional form between spindle cell lipoma and solitary fibrous tumor, and should be distinguished from myxiod liposarcoma and myxoid malignant fibrous histiocytoma. Due to the benign nature of this lesion, simple local excision is curative.
研究树突状纤维黏液脂肪瘤的临床病理特征，以便将其与其他易混淆的软组织肿瘤相鉴别。
获取8例树突状纤维黏液脂肪瘤病例，并对其临床病理特征进行研究。采用标记链霉亲和素-生物素（SLAB）系统，在DAKO自动免疫组织化学染色仪上对CD34、bcl-2、波形蛋白、细胞角蛋白、上皮膜抗原（EMA）、S-100、HHF35和平滑肌肌动蛋白进行免疫组织化学染色。
树突状纤维黏液脂肪瘤通常发生于中老年男性，主要位于头颈部、肩部、背部、小腿和足部的皮下或肌筋膜。大体上，肿瘤边界清楚，部分有薄包膜，切面呈局灶性黏液样或胶冻样。组织学上，所有这些肿瘤均表现出相似的组织学特征，其特点是成熟脂肪组织、梭形细胞和星状细胞混合存在，伴有大量黏液样基质和明显的胶原化。上述成分的比例在不同肿瘤或同一肿瘤的不同区域有所不同。病理特征之一是梭形细胞和星状细胞增生，其胞质有细的树突状延长。未发现细胞学异型性或有丝分裂活性。此外，病变血管丰富，血管成分包括小至中等大小的丛状血管和毛细血管样血管。梭形细胞对CD34、bcl-2和波形蛋白呈强阳性，而对S-100蛋白以及上皮和肌肉标志物呈阴性。
树突状纤维黏液脂肪瘤具有临床病理和免疫组织化学特征。基于该肿瘤的这些特征，它似乎代表了梭形细胞脂肪瘤和孤立性纤维瘤之间的一种过渡形式，应与黏液样脂肪肉瘤和黏液样恶性纤维组织细胞瘤相鉴别。由于该病变为良性，单纯局部切除即可治愈。
