Lombardi A, Spagnoli A M, Leone Sossi F, Caratozzolo M, Graziano P, Di Paola M, Marinozzi V
Policlinico Umberto, IV Clinica Chirurgica, Università degli Studi di Roma, La Sapienza.
Minerva Chir. 1996 May;51(5):365-8.
This paper reviews a case of nodular (pseudosarcomatous) fasciitis. It consists of a rare benign lesion of the soft tissues. The rapidity of its growth and the cellular features represent a diagnostic challenge when compared with that of a sarcoma. The patient, a 36 year old female, 20 days before surgical treatment, noticed the growth of a nodular lesion on the left forearm skin. After echotomography and ultrasound guided needle biopsy diagnosis of nodular pseudosarcomatous fasciitis was established and the patient underwent surgical treatment. The nodular lesion, noncapsulated, (diameter 2.5 x 1.2 cm) greyish-white colored, with slimy consistency, and myxoid character, was microscopically composed by atypical fibroblasts, with myxoid ground substance. The nodular lesion was removed using the "pressure" technique by Serge Baux of Rothschild Hospital in Paris using two Kirschner threads pulling the skin surrounding the biopsy wound. By this technique was possible to achieve a rapid skin expansion. The nodular pseudosarcomatous fasciitis remains a very difficult lesion to recognise unless the aid of a biopsy.
本文回顾了一例结节性(假肉瘤性)筋膜炎病例。它是一种罕见的软组织良性病变。与肉瘤相比,其生长速度和细胞特征构成了诊断挑战。患者为一名36岁女性,在手术治疗前20天,发现左前臂皮肤出现一个结节性病变。经超声断层扫描和超声引导下针吸活检后,确诊为结节性假肉瘤性筋膜炎,患者接受了手术治疗。该结节性病变无包膜,直径2.5×1.2厘米,灰白色,质地黏腻,具有黏液样特征,显微镜下由非典型成纤维细胞和黏液样基质组成。采用巴黎罗斯柴尔德医院的塞尔日·博克斯的“加压”技术,使用两根克氏针牵拉活检伤口周围的皮肤,切除了结节性病变。通过这种技术能够实现快速的皮肤扩张。除非借助活检,否则结节性假肉瘤性筋膜炎仍然是一种很难识别的病变。