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报告1例临床表现为靶样损害的动脉瘤样纤维组织细胞瘤。患者女,60岁。因左大腿内侧结节1个月余就诊。皮肤科检查:左大腿内侧可见一直径约1 cm,黑褐色结节,边缘环绕紫红色晕,无触痛。皮损手术全切行组织病理检查示表皮角化过度,表皮突下延,基底层色素增加,真皮浅中部增生的纤维组织细胞及胶原纤维形成境界清楚的团块,其内可见血窦样结构,但无血管内皮细胞,并可见含铁血黄素沉积,无细胞异形性,普鲁士蓝染色阳性。免疫组化肿瘤细胞不表达Ⅷ因子、CD34、CD31、S-100蛋白、平滑肌肌动蛋白(SMA)、结蛋白(desmin)、细胞角蛋白(CK)和CD68,而波形蛋白(vimentin)阳性表达。结合临床诊断表现为靶样损害的动脉瘤样纤维组织细胞瘤。术后随访6个月余未见复发或转移。
One case of aneurysm-like fibrous histiocytoma with clinical manifestations as target lesion was reported. Female patient, 60 years old. Due to the left thigh medial nodules more than 1 month treatment. Dermatology examination: a diameter of about 1 cm can be seen on the inside of the left thigh, dark brown nodules, edges around the purple dizzy, no tenderness. Histopathological examination showed that the epidermis was hyperkeratotic, epidermal processes were delayed, the basal layer of pigment increased, the superficial dermis hyperplasia of fibrous tissue cells and collagen fibers to form a clear clumps, which can be seen within the sinusoid structure , But no vascular endothelial cells, and visible deposition of hemosiderin, cell-shaped heterogenous, Prussian blue staining. Immunohistochemical tumor cells did not express factor Ⅷ, CD34, CD31, S-100 protein, SMA, desmin, CK and CD68, while vimentin was positive . Aneurysmal Fibrous Histiocytoma combined with clinical diagnosis of target damage. No recurrence or metastasis was observed after 6 months of follow-up.