GF Ingrassia Department, Section of Anatomic Pathology, Policlinico Universitario-Vittorio Emanuele, University of Catania, 95123 Catania, Italy.
Hum Pathol. 2012 Feb;43(2):243-53. doi: 10.1016/j.humpath.2011.04.027. Epub 2011 Aug 4.
We analyzed the clinicopathologic features of 10 cases of vulvovaginal myofibroblastoma to widen its morphological and immunohistochemical spectrum. Most tumors (8/10 cases) were located in the vagina. The patients' age ranged from 44 to 77 years, and tumor size ranged from 0.4 to 3 cm. Histologically, 5 tumors had the characteristics of vulvovaginal myofibroblastoma. In addition, we identified 3 cases composed of spindle-shaped cells arranged in short fascicles with intervening thick collagen bands, closely reminiscent of mammary myofibroblastoma. Notably, 1 case resembled Sertoli cell tumor, sclerosing type, because of its predominant cord-like arrangement. In another case, there were highly cellular areas composed of uniform-packed, rounded cells that, at low magnification, looked like a malignant "small round blue cell tumor." A variably thick band of native connective tissue separated tumors from the overlying squamous epithelium even if, in 3 cases, tumor cells extended up to the epithelium. In 7 cases, a variable number of vessels showed perivascular hyalinization. Only rare mitotic figures were identified. All tumors were diffusely positive for vimentin, desmin, and CD99. A variable staining intensity was observed for CD34, Bcl-2, B-cell lymphoma 2 (Bcl-2) CD10, estrogen receptor, and progesterone receptor in most cases, but none expressed α-smooth muscle actin. We emphasize that vulvovaginal myofibroblastoma encompasses a morphological spectrum wider than previously described. The overlapping morphological and immunohistochemical features of vulvovaginal and mammary myofibroblastomas led us to speculate that these are related entities with morphological variations on a common basic theme likely dependent on anatomical location.
我们分析了 10 例外阴阴道肌纤维母细胞瘤的临床病理特征，以拓宽其形态学和免疫组织化学谱。大多数肿瘤（8/10 例）位于阴道。患者年龄 44-77 岁，肿瘤大小 0.4-3cm。组织学上，5 例具有外阴阴道肌纤维母细胞瘤的特征。此外，我们还发现 3 例由短束状排列的梭形细胞组成，其间有厚的胶原带，与乳腺肌纤维母细胞瘤密切相似。值得注意的是，1 例因主要呈索状排列，类似于 Sertoli 细胞瘤，硬化型。在另 1 例中，有高度细胞区域由均匀排列的圆形细胞组成，在低倍镜下，看起来像恶性的“小圆蓝细胞肿瘤”。固有结缔组织的可变厚带将肿瘤与上皮分离，即使在 3 例中，肿瘤细胞也延伸到上皮。在 7 例中，可见数量不等的血管有血管周围玻璃样变。仅偶尔可见有丝分裂象。所有肿瘤均弥漫性表达波形蛋白、结蛋白和 CD99。CD34、Bcl-2、B 细胞淋巴瘤 2（Bcl-2）、CD10、雌激素受体和孕激素受体在大多数病例中呈可变强度染色，但均不表达α-平滑肌肌动蛋白。我们强调外阴阴道肌纤维母细胞瘤包含比以前描述的更广泛的形态学谱。外阴阴道和乳腺肌纤维母细胞瘤的重叠形态学和免疫组织化学特征使我们推测这些是相关的实体，具有共同基本主题上的形态学变异，可能取决于解剖位置。
