Shinohara Yuki, Nishio Jun, Nakayama Shizuhide, Koga Mikoro, Aoki Mikiko, Koga Takamasa
Section of Orthopaedic Surgery, Department of Medicine, Fukuoka Dental College, Fukuoka, Japan.
Section of Orthopaedic Surgery, Department of Medicine, Fukuoka Dental College, Fukuoka, Japan;
In Vivo. 2025 Mar-Apr;39(2):613-620. doi: 10.21873/invivo.13866.
Fibroma of tendon sheath (FTS) is a benign fibroblastic/myofibroblastic neoplasm that primarily occurs in the fingers and hands of young and middle-aged adults. The lesion typically presents as a small, firm, slow-growing, painless nodule. Ultrasonography usually shows a focal nodular mass with homogeneous hypoechogenicity. Magnetic resonance imaging reveals a well-defined nodular mass with decreased signal on all pulse sequences. No or minimal peripheral enhancement is often seen after intravenous contrast. Histologically, the lesion is well circumscribed and consists of bland spindle cells in a dense collagenous stroma with slit-like thin-walled vessels at the periphery. A cellular variant of FTS has also been described and shows at least a focal morphological overlap with nodular fasciitis. Immunohistochemistry does not play a significant role in the diagnosis of FTS. Cytogenetic studies have demonstrated the presence of 11q rearrangements. A significant subset of cellular variants of FTS are characterized by ubiquitin specific peptidase 6 (USP6) rearrangements, with a variety of fusion partners. Complete surgical excision is the treatment of choice. This review provides an updated overview of the clinical, radiological, histological, cytogenetic and molecular genetic features of FTS and discusses the differential diagnosis of this uncommon entity.
腱鞘纤维瘤（FTS）是一种良性成纤维细胞/肌成纤维细胞肿瘤，主要发生于中青年的手指和手部。该病变通常表现为一个小的、质地硬、生长缓慢、无痛的结节。超声检查通常显示一个局灶性结节状肿块，回声均匀减低。磁共振成像显示一个边界清晰的结节状肿块，在所有脉冲序列上信号均减低。静脉注射造影剂后，通常可见无或极少的周边强化。组织学上，病变边界清晰，由密集胶原基质中的温和梭形细胞组成，周边有裂隙状薄壁血管。FTS的细胞型也已被描述，并且显示出与结节性筋膜炎至少有局灶性形态学重叠。免疫组化在FTS的诊断中作用不大。细胞遗传学研究已证实存在11q重排。FTS细胞型的一个重要亚组以泛素特异性肽酶6（USP6）重排为特征，有多种融合伴侣。完整手术切除是首选治疗方法。本综述提供了FTS临床、放射学、组织学、细胞遗传学和分子遗传学特征的最新概述，并讨论了这个不常见实体的鉴别诊断。
