腮腺结节性筋膜炎少见,本文报道1例儿童腮腺内结节性筋膜炎。患者,男,10岁,1月余前无意间发现左耳后包块入院。镜下形态示:肿瘤细胞丰富,细胞呈梭形,胞浆中等,弱嗜酸性,细胞核大。间质内见外渗的红细胞和散在的淋巴细胞浸润。免疫组化染色结果:Vim、SMA、β-Catenin均为阳性,Ki67指数约30%,Desmin、EMA、S-100、SOX-10、CD34、STAT6、ALK均为阴性。基因检测结果:USP6 (17p13)基因重排,FISH阳性。病理诊断:结合免疫组化及FISH检测结果,符合结节性筋膜炎。腮腺结节性筋膜炎少见,因其细胞增生活跃,容易被误诊为肉瘤样病变,应该注意鉴别诊断,避免误诊。Nodular fasciitis in the parotid gland is rare. This article reports a child with intraparotid nodular fasciitis. A 10-year-old male patient was admitted to the hospital due to an accidental mass found behind the left ear more than 1 month ago. Under the microscope:the tumor cells are abundant, spindle shaped, with moderate cytoplasm, weak eosinophilia, and large nuclei. Extravasated red cells and scattered lymphocytic infiltrates were seen in the stroma. Immunohistochemical staining showed that Vim, SMA and β-Catenin were positive, Ki67 index was about 30%, Desmin, EMA, S-100, SOX-10, CD34, STAT6 and ALK were negative. Genetic test results: USP6 (17p13) gene rearrangement, FISH positive. Pathological diagnosis: the results of immunohistochemistry and FISH were consistent with nodular fasciitis. Nodular fasciitis of the parotid gland is rare. Due to its active cell proliferation, it is easy to be misdiagnosed as sarcomatoid lesions. Attention should be paid to the differential diagnosis to avoid misdiagnosis.
