Balachandran K, Allen P W, MacCormac L B
Histopathology Department, Queen Elizabeth Hospital, Woodville, Australia.
Am J Surg Pathol. 1995 Mar;19(3):313-7.
Nuchal fibroma apparently was first described in the second edition of Enzinger's and Weiss's text book in 1988. We have been unable to find any other accounts of this entity. We have reviewed the clinicopathological features of nine nuchal fibromas, eight of which were referred in consultation. Eight patients were men; the ages ranged from 19 to 53 years (median, 43). Patients were first seen with solitary, unencapsulated, subcutaneous swellings in the back of the neck or dorsal region measuring from 2.5 to 8 cm in maximum dimensions (median, 3.5). Macroscopically, lesions were firm, fibrofatty masses. Histologically, there were sheets of hypocellular dense collagen with interspersed mature fat, inconspicuous, small, thin-walled vessels, and entrapped nerve fibers. The picture suggested a fibrolipoma, a lipomatosis, scar tissue, or even elastofibroma, but the small amount of elastic tissue present lacked the beaded, nodular appearance of elastofibroma. Follow-up information was available in seven cases. In follow-up times from 6 months to 19 years (median, 6 years), one tumor was reexcised 4 months after an incisional biopsy and had not recurred 19 months later. None of the others recurred. The lack of a capsule, the entrapment of nerves, and the predilection for the nuchal or dorsal regions suggest that this hypocellular, benign, fibrofatty lesion is a distinct entity and not merely a lipoma.
项部纤维瘤显然是在1988年恩津格和魏斯的教科书第二版中首次被描述的。我们未能找到关于这个实体的任何其他记载。我们回顾了9例项部纤维瘤的临床病理特征，其中8例是会诊转诊而来。8例患者为男性；年龄范围为19至53岁（中位数为43岁）。患者初诊时表现为颈部后方或背部的孤立性、无包膜的皮下肿物，最大直径为2.5至8厘米（中位数为3.5厘米）。大体上，病变为坚实的纤维脂肪性肿块。组织学上，有大量细胞稀少的致密胶原，其间散在成熟脂肪、不明显的小薄壁血管和包埋的神经纤维。这种表现提示为纤维脂肪瘤、脂肪瘤病、瘢痕组织，甚至弹性纤维瘤，但存在的少量弹性组织缺乏弹性纤维瘤的串珠状、结节状外观。7例患者有随访信息。随访时间为6个月至19年（中位数为6年），1例肿瘤在切开活检后4个月再次切除，19个月后未复发。其他患者均未复发。缺乏包膜、神经包埋以及对项部或背部区域的偏好表明，这种细胞稀少的良性纤维脂肪性病变是一个独特的实体，而不仅仅是脂肪瘤。
