˘ˇˆ˙˝˛ 1 - Marianna Uigakukai.marianna-u.ac.jp/idaishi/www/375/05-37-8Yasushi Ariizumi.… ·...

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臆腟腠腝腡腞腧腯臕腷膠膧 Vol. 37, pp. 393396, 2009 腍腜腐腇腗腒腂腀 腕腘腕腎腑腆腈腌腙腁腏腖腄腅腃 腓腋腊腝腚腔腉腑腈 1 腂腡 腃腐腛 腝腏腍 腅腣 腖腄 腂腇腠 腇腑 腎腚 腆腐 腜腣 腒腃 腏腊 腚腌 腕腜 腚腅 腃腓 腢腄 腙腗 腃腊 膲膰 腎腞腣腇 膸臊 腋腃腐腛 腘腢 腑腆 腑腆 腚腌 腟腇 膯臹 : 21 8 14 臇腳腮腜腋臋腦膮 Calcifying aponeurotic fibroma; CAF腒膚腓腍腐 0 64 膜腓腍腑臲 膹臯膘腆腚腙腼腏膮臲膹膃臯12 膜腑膸膩腑膢膥腬腤臺腐膓臲腈腙腎腆 腚腌腁腙臎膼腷臢腐腒臋腦腰膝腑臸腽臑腏臐臅腎臷臜膽臺腑臬膙膅臂腖臇腳腮腃自臝臢 腎腆腚腙膬腸腍腀腙膫膏70 膜膶臁腑腪膪膤致腭腐臲臅腇腊膮臎膼腷臢腐腒臷膽腐臦膻腐臇腳腮腃臮腕腘腚臬膙膅臂腃腛腉腂腐腔腘腚腊臇腳腮腖臬膙膝膱腥腐腒臗膿膅臋腦腰膝腑臸腽臑腏臐臅腃臮腕腘腚CAF 腎膾臘腇腊膫膏70 膜腎膗膭腍腚腓腍腑臼膍膘膺腍腒膛膗CAF 1 腜膈膏腇腊腑腍膘腈腙腈腀腓腇 臇腳腮腜腋臋腦膮臬臺膮calcifying aponeurotic fibroma, soft tissue tumor 臇腳腮腜腋臋腦膮 calcifying aponeurotic fibroma 腣腭 CAF1953 臯腐 Kessbey 1腐腗腋腌膴腕腌 juvenile aponeurotic fibroma 腎腇腌膘腆腚腊膸膩腐膓臲腈腙腼腏膬腸腍腀腙臎膼腷臢腐腒臋腦 腰膝腑臸腽臑腏臐臅腎臷臜膽臺腑臬膙膅臂腖臇 腳腮腃自臝臢腎腆腚腙膬腸腍腀腙膚腱 70 膜腍臲膎腆腚臼膍膌膟膺腍腒 70 膜腎膛 腍腀腋腊臲膎腑臬膙膅臂膮腍腀腙腅腎 腂腘臬臺臬膙膮腎腑腹腇腊 CAF 1 膈膏腇腊腑腍膘腈腙: 70 膶臁腅腑腖: 膯膾腑 4 臯臍腂腘腪膪膤腐膮腜膫腵腇腌 腁腊膫臲臡腖腢臡腒臮腕腘腚腉腑臐臕膄膒 腒臮腕腘腚腏腂腋腊腃臈膷腜腻腇臧腩腜膯膾腇 腪膪膤腑膤臻臺腐膸臩臕腑膮腃臮腕腘腚X 臋臏 Figure 1腍腒致腭腐膐膂臁腑膮臞腃臮 腕腘腚腊腃臇腳腮腖膙臱腲臏腒臮腕腘腚腏腂腋 膱腥臎膼腎腑臛腒膉臤腍腛腃腫腜腺腕腌 腑膂膵臈膷腃膕腛腚腊腃腁腖: 自腾膨膖腏腇腂腏腖: 自腾膨膖腏腇腑腔腎腍腉腄: 腒腪膪膤腑致腭膦膼臫腐臒膞 腆腏腁膱腥腎腑膁腴腃至腶臢腌腖腏臷 腑臕腄腆腒臟膆0.60.6 cm 臕腍腀腋 臎膼腷臢腐腒膊臉臁臷臫腐腒臦膻腐 臬膙膝腃膸臀腔腘腚膡膞臁腐臸臃腏臇腳腮腃臓 臀臮腕腘腚腊 Figure 2a臇腳腮腖臬膙膝腑膱 腥腐腒臗膿膅腑臋腦腰膝臐臅腃腔腘腚腨臺腍 臆腟腠腝腡腞腧腯臕腷 膾臘臷393 75

Transcript of ˘ˇˆ˙˝˛ 1 - Marianna Uigakukai.marianna-u.ac.jp/idaishi/www/375/05-37-8Yasushi Ariizumi.… ·...

Page 1: ˘ˇˆ˙˝˛ 1 - Marianna Uigakukai.marianna-u.ac.jp/idaishi/www/375/05-37-8Yasushi Ariizumi.… · 2 ˘ 345# ˇˆ˙˝˛˚6 7˚ ... Daisuke Kumon, Masatomo Doi, Ichirou Maeda, Mieko

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CAF� 1953[�Kessbey1��\5]^�] juve-nile aponeurotic fibroma *P]�_G��`a"=-� bc���#d*+,��]e�0� bc4�f[g� h�i�g�Vj�F��-H*4�kl� CAF *mnG�� opqr`a"� s�t!60 bc4� 10u"��_"=-� WHO 6�� Tumours of Soft Tissue and Bone2� �\-*�Vd[�� 0 v�64 vw"�Vj0�_G�� Vd�x[�� 12v� yzo�y3�{�Vj|-*G�-� }~�� 70v�Vd"� �?�������Web �* NCBI � Pub Med " ��������#�w�� �calcifying aponeurotic fibroma�������*P]��P�*H�� ���_����P�-��"�i[���_"=5�� ���13���3�����:� ZV!{����{!

���� ��� KL!� ��  ¡!"=-*G�-0� ¢!� £�� �!��Vj�0=-3�� �¤./*P]�¥¦�§t|-�¨3#�"� t©G� 3 cmª«�H*0�¬� ­®./��CA¯�°e#�*P]����-H*0�e� %&?q�±*P]²³3�DE´µ�DE���0����� ²³¶������·��¸´�����§j0����-H*0�±*G�� ¹E2����������-*G�-�

Figure 1. Plain X-ray image of the right fingers of our

CAF patient.

Swelling of the right forefinger �arrow� is evident, butthe bone is intact.

a

b

Figure 2. Microscopic analyses of resected tissue.

a: Low magnification views revealing nodules of fibro-

lastic proliferation with multiple islands of calcifying

formation in the nodule.

b: High magnification views revealing islands of cal-

cification surrounded by fibroblasts. The fibroblasts

with the CAF tumor are irregularly arranged in a

fascicular and palisading pattern. The tumor cells

show neither nuclear atypia nor mitotic figures.

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��������� �� �������� ������� ����� ������� !"#$� %�&'�()*+ ,-./�01"#2� �����345#� �������6�7�����89:�;<=��>?@A'BC'�DEF01$=�G"HI�J� ��������KL8M�� NOPQ'RS�� ��T()UV8WX' myxoid ;YZF[\=��]^�5#� _`a b()�[c;<=��d<>?ef$� �������Eg8����'RS�� ��T()UVF01$���hi�8>?j�� _`a �DE�01;<>?�5#$� kl&�m�8NOno8pq'SV�� �DE b()F[\=�G"� ������� �������34�J� ��� 30�60rs8Eg8�p'RSt$>?e� 1�2 cmu8vw�8xyz{;��FDE�� E|�J}~��eDE5#$-�C8>?e� �'��@A'_`aF[\�5#$� CAF ��RSQ����� Eg& CAF�8�������;>?ef$� Weiss4� '�$� CAF '�����'� ��'��8���]^� !"#� ��/���/'-�"#$� ��/���� ����'d�� ����'UV�� _`a�[c;<=��d<�5#� �������'��t$�5#$� ��/����>?F���_`a �DE����>?�5#� _`aF[\���8�����ef$�5#$� kl&� �S�8���>?e� �¡8>¢£%¤E

�'��>?�E|�J}~��eDE5#$vw�xyz{;-�C>?e�;�� K¥8����>?¦'BC'§¨t$8©e� _`a�©"#;GªJ=�G"���8�����efªJ� £%8«¬­¬®F¤¯�J�°� CAF']^�;_`a���T()@'©"#JJ1���/8]^F±t$ CAF ����J�70r8²�'SV�J CAF 8 1&F³l�J�

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1� Keasbey LE. Juvenile aponeurotic fibroma �cal-cifying fibroma�. A distinctive tumor arising inthe palms and soles of young children. Cancer

1953; 6: 338�346.2� McMenamin ME. WHO classification of Tu-mours: Tumours of Soft tissues and Bone.

IARC press, Lyon 2002; 69�70.3� John FF, Markku M. Calcifying aponeuroticfibroma: A clinicopathological study of 22 cases

arising in uncommon sites. HumPathol 1998; 29:

1504�1510.4� Enzinger FM, Weiss SW. Soft tissue tumors. 5th

edition. St Louis: Mosby; 2008; 289-293.

 ��8 Calcifying aponeurotic fibroma 8 1& 395

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Abstract

Calcifying Aponeurotic Fibroma Occurrinng in a Seventy Year Old Female

Yasushi Ariizumi, Akira Endo, Kazuki Kitajima, Daisuke Kumon,

Masatomo Doi, Ichirou Maeda, Mieko Hunatsu, Junki Koike,

Hirotaka Koizumi, and Masayuki Takagi

Calcifying aponeurotic fibroma �CAF� is a rare soft tissue tumor that typically arises in the distalextremities in children and adults. The reported age range for this disease is 0 to 64 years, with a median of

12 years. The histological features of CAF include central foci of calcification and cartilage formations

surrounded by proliferating fibroblasts. We here report a CAF case in a 70-year-old female. The tumor in

this patient was detected in the subcutaneous tissue of the distal finger and histologically showed typical

features of CAF. To our knowledge, this is the oldest diagnosed case of this disease.

Department of Diagnostic Pathology, St Marianna University School of Medicine

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