Asadi Amoli Fahimeh, Sina Amir Hossein, Kasai Aboulfazl, Ayan Zahra
Department of Pathology, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Acta Med Iran. 2010 Nov-Dec;48(6):412-6.
Myofibroma is a neoplasia of myofibroblasts that can be solitary or multiple and it is found most commonly in the head & neck region including scalp, forehead, parotid region and oral cavity. In the eyelid it is rarely reported. It has a benign course in the solitary form and fatal in its multiple form. A 4 month male infant referred to Farabi hospital -the referral center for eye diseases- with a 2 month history of a mass in his eyelid with gradual enlargement with no other complaints. The only abnormal physical finding was a 2.5 cm mass in the eyelid. This mass was excised and sent to the hospital pathology laboratory. When confronting a spindle cell lesion with a nodular or multinodular growth pattern which appears biphasic due to alteration of light and dark staining areas, the surgical pathologist should think to the possibility of myofibroma. Its pattern of growth and architecture rules out the other differential diagnoses like nodular fasciitis, fibrous histiocytoma, infantile fibromatosis, and peripheral primitive neuroectodermal tumor, mesenchymal chondrosarcoma, malignant hemangiopericytoma, juvenile fibrosarcoma and poorly differentiated synovial sarcoma. In difficult cases immunohistochemical staining is helpful that is Vimentin & Actin positivity & Desmin, CK, EMA & S100 negativity.
肌纤维瘤是一种肌成纤维细胞的肿瘤，可单发或多发，最常见于头颈部，包括头皮、前额、腮腺区和口腔。在眼睑部位鲜有报道。单发形式病程呈良性，多发形式则可致命。一名4个月大的男婴被转诊至法拉比医院（眼病转诊中心），其眼睑有肿物2个月，且逐渐增大，无其他不适主诉。唯一异常的体格检查发现是眼睑有一个2.5厘米的肿物。该肿物被切除并送至医院病理实验室。当面对一个呈结节状或多结节生长模式的梭形细胞病变，因其明暗染色区域的改变而呈现双相性时，外科病理学家应考虑肌纤维瘤的可能性。其生长模式和结构可排除其他鉴别诊断，如结节性筋膜炎、纤维组织细胞瘤、婴儿纤维瘤病、外周原始神经外胚层肿瘤、间叶性软骨肉瘤、恶性血管外皮细胞瘤、青少年纤维肉瘤和低分化滑膜肉瘤。在疑难病例中，免疫组化染色有助于诊断，即波形蛋白和肌动蛋白阳性，结蛋白、细胞角蛋白、上皮膜抗原和S100阴性。
