转移性细胞性纤维组织细胞瘤致死病例：病例报告及文献复习
Fatal case of metastatic cellular fibrous histiocytoma: case report and review of literature.
作者信息
Lodewick Evelyne, Avermaete Annelies, Blom Willem A M, Lelie Bart, Block Ronald, Keuppens Marie
机构信息
*Department of Dermatology, ZorgSaam Hospital, Terneuzen, The Netherlands; †Department of Dermatology, University Hospital Ghent, Belgium; ‡Department of Pathology, ZorgSaam Hospital, Terneuzen, The Netherlands; and §Department of Respiratory Medicine, ZorgSaam Hospital, Terneuzen, The Netherlands.
出版信息
Am J Dermatopathol. 2014 Sep;36(9):e156-62. doi: 10.1097/DAD.0b013e318299f28c.
BACKGROUND
Cellular fibrous histiocytoma was first described in 1994 as a distinct variant of fibrous histiocytoma. Since then, at least 21 cases of cellular fibrous histiocytomas metastasizing to regional lymph nodes and/or lungs have been described, though not all fatal.
CASE
We report the case of a 68-year-old male patient who presented with a large ulcerated skin tumor on the left thigh. The lesion was urgently excised. Histopathological examination led to the diagnosis of cellular fibrous histiocytoma. Nine months later, the patient presented with progressive dyspnea. A thoracoabdominal computed tomography revealed diffusely spread nodular lung lesions. A lung biopsy confirmed them to be metastases of the cellular fibrous histiocytoma. The condition of the patient quickly deteriorated, and he deceased 2 months later.
CONCLUSIONS
Given the possible aggressive nature of cellular type of fibrous histiocytoma, we advice complete excision and clinical follow-up. Chest x-rays and ultrasound examination of regional lymph nodes should be performed in atypical lesions.
背景
细胞性纤维组织细胞瘤于1994年首次被描述为纤维组织细胞瘤的一种独特变体。自那时以来，至少有21例细胞性纤维组织细胞瘤转移至区域淋巴结和/或肺部的病例被报道，尽管并非所有病例都是致命的。
病例
我们报告了一名68岁男性患者的病例，该患者左大腿出现一个大的溃疡性皮肤肿瘤。病变被紧急切除。组织病理学检查诊断为细胞性纤维组织细胞瘤。9个月后，患者出现进行性呼吸困难。胸腹计算机断层扫描显示肺部有弥漫性分布的结节性病变。肺活检证实这些病变为细胞性纤维组织细胞瘤的转移灶。患者病情迅速恶化，2个月后死亡。
结论
鉴于细胞性纤维组织细胞瘤可能具有侵袭性，我们建议进行完整切除并进行临床随访。对于非典型病变，应进行胸部X光检查和区域淋巴结超声检查。
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