Elpek Gülsüm Ozlem, Küpesiz Gökben Yildirim, Ogüs Mehmet
Department of Pathology, Akdeniz University Medical School, Akdeniz, Antalya, Turkey.
Pathol Int. 2006 Apr;56(4):227-31. doi: 10.1111/j.1440-1827.2006.01951.x.
Calcifying fibrous tumor (CFT) is an uncommon lesion of uncertain cause and pathogenesis that has a unique histological appearance. These lesions are described mainly in the subcutaneous or deep soft tissues, followed by subserosal locations. Intrinsic visceral CFT is extremely rare. Herein is described a rare case of CFT that involved the gastric wall, along with a review of the literature. An incidental small polypoid lesion was excised during urgent surgery for penetrating injury at the lesser curvature in a 25-year-old man, previously healthy. The lesion was a well-demarcated, small (10 mm) tumor that occupied the submucosa. The characteristic histopathological features and the presence of spindle cells that express factor XIIIa allowed a diagnosis of CFT to be made. The present case and the review revealed that, despite their frequent subperitoneal location, intra-abdominal CFT might present as intrinsic visceral lesions and might be found incidentally. These lesions tend to be smaller when compared to their symptomatic counterparts. The diffuse factor XIIIa expression in CFT might be useful to differentiate this entity from other intra-abdominal soft-tissue tumors in problematic cases. Although rarity of intrinsic visceral CFT necessitates new cases to determine their exact biological behavior, the present case highlights their presence in the stomach as a symptomless small polypoid lesion.
钙化性纤维瘤（CFT）是一种病因和发病机制不明的罕见病变，具有独特的组织学表现。这些病变主要见于皮下或深部软组织，其次为浆膜下部位。内脏原发性CFT极为罕见。本文描述了1例累及胃壁的罕见CFT病例，并对相关文献进行了回顾。一名25岁既往健康的男性因胃小弯穿透伤接受急诊手术，术中意外切除了一个小的息肉样病变。该病变为边界清晰的小肿瘤（10mm），位于黏膜下层。其特征性的组织病理学表现以及表达因子ⅩⅢa的梭形细胞的存在，使得CFT得以确诊。本病例及文献回顾显示，尽管腹腔内CFT常位于腹膜下，但也可能表现为内脏原发性病变，且可能为偶然发现。与有症状的病变相比，这些病变往往较小。在疑难病例中，CFT中弥漫性的因子ⅩⅢa表达可能有助于将其与其他腹腔内软组织肿瘤相鉴别。虽然内脏原发性CFT罕见，需要更多新病例来确定其确切生物学行为，但本病例突出了胃内存在无症状小息肉样病变这一情况。
