Luis Pedro P, Quiñonez Enoe, Nogales Francisco F, McCluggage W Glenn
Departments of Pathology, Hospital de Santa Maria, Lisbon, Portugal (P.P.L.) San Cecilio University Hospital (E.Q., F.F.N.), Granada, Spain Royal Group of Hospitals (W.G.M.), Belfast, United Kingdom.
Int J Gynecol Pathol. 2015 Mar;34(2):204-7. doi: 10.1097/PGP.0000000000000131.
We report 3 cases of the extremely rare lipomatous variant of angiomyofibroblastoma (AMF) involving the vulva of women aged 35, 45, and 47. The lesions ranged in size from 2.5 to 12 cm in maximum dimension and the largest had a gross "fatty" appearance. The percentage of adipose tissue was approximately 50% in 1 case and over 90% in the other 2. In all the cases, there was a background of typical AMF with bland spindled and epithelioid cells arranged around blood vessels, although in the cases with >90% adipose tissue, this was subtle and diffusely interspersed with the adipose tissue. In all the cases, the spindled and epithelioid cells were positive with estrogen receptor. Given the morphologic features, misdiagnosis as a lipomatous neoplasm is likely, especially in cases with a minor component of typical AMF. We review the literature on lipomatous AMF and discuss the differential diagnosis.
我们报告了3例极其罕见的血管肌成纤维细胞瘤（AMF）的脂肪瘤样变体，累及35岁、45岁和47岁女性的外阴。病变最大直径为2.5至12厘米，最大的病变外观呈肉眼可见的“脂肪样”。1例脂肪组织百分比约为50%，另外2例超过90%。在所有病例中，均存在典型AMF的背景，有温和的梭形细胞和上皮样细胞围绕血管排列，尽管在脂肪组织>90%的病例中，这种情况不明显且与脂肪组织弥漫性穿插。在所有病例中，梭形细胞和上皮样细胞雌激素受体均呈阳性。鉴于其形态学特征，尤其是在典型AMF成分较少的病例中，很可能被误诊为脂肪瘤性肿瘤。我们回顾了关于脂肪瘤样AMF的文献并讨论了鉴别诊断。
