Fletcher C D
Department of Histopathology, St. Thomas's Hospital Medical School, London, England.
Am J Surg Pathol. 1990 Sep;14(9):801-9.
Twenty-one cases of benign fibrous histiocytoma arising in noncutaneous soft tissue are reported. These tumors presented most often in young to middle-aged adults with a predominance in males. They originated in deep subcutis (16 cases), skeletal muscle (three cases), and mesentery (two cases). The most common sites of incidence were the lower limb (eight cases) and head and neck region (six cases). Four of 12 cases with follow-up (median 3.0 years) recurred locally; all had originated in the subcutis. None metastasized. These lesions are generally larger and better circumscribed than their cutaneous counterparts. They are also usually more monomorphic and have a more consistent storiform pattern than the latter. A pericytomalike vascular pattern (six cases), xanthoma cells (six cases), and multinucleate giant cells (six cases) may be prominent. Hyaline or myxoid degeneration of the stroma is common. Rare features include small foci of necrosis and intravascular growth. Immunohistochemically, deep benign fibrous histiocytoma shows no evidence of true monocyte/macrophage differentiation and its histogenesis remains uncertain. The differential diagnosis includes malignant fibrous histiocytoma, dermatofibrosarcoma and hemangiopericytoma.
本文报告了21例发生于非皮肤软组织的良性纤维组织细胞瘤。这些肿瘤多见于中青年成人，男性居多。它们起源于深部皮下组织（16例）、骨骼肌（3例）和肠系膜（2例）。最常见的发病部位是下肢（8例）和头颈部（6例）。12例接受随访（中位随访时间3.0年）的患者中有4例局部复发；所有复发患者均起源于皮下组织。无一例发生转移。这些病变通常比其皮肤对应病变更大，边界更清晰。它们通常也更单一，并且比后者具有更一致的席纹状结构。血管外皮瘤样血管模式（6例）、黄色瘤细胞（6例）和多核巨细胞（6例）可能较为突出。间质的透明变性或黏液样变性很常见。罕见特征包括小灶性坏死和血管内生长。免疫组织化学检查显示，深部良性纤维组织细胞瘤无真正单核细胞/巨噬细胞分化的证据，其组织发生仍不确定。鉴别诊断包括恶性纤维组织细胞瘤、皮肤纤维肉瘤和血管外皮细胞瘤。
