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目的探讨胃血管球瘤(glomus tumor,GT)的临床、病理学特征以及诊断和鉴别诊断。方法报道1例发生在胃部的GT,对其进行组织学、免疫组化检查并复习近35年文献。结果胃GT临床上多发于中年女性,好发于胃窦部,常见症状为上腹部疼痛;其形态学特点表现为肿瘤组织呈结节状,肿瘤细胞大小较一致,胞质透亮或嗜酸性,核圆形,瘤细胞排列成实性或围绕血管周围排列;免疫组化标记显示肿瘤细胞vimen-tin、SMA、actin、calponin均为(+),CK、CD117、Syn、S-100、EMA、desmin、CD99、CD34均(-)。结论胃GT临床上缺乏特异性症状,主要表现为上腹部疼痛,生物学行为多为良性,目前最有效的治疗方法是手术切除。其具有特定的形态学特征和免疫表型,需与其他肿瘤,如上皮样胃间质瘤、类癌等相鉴别。
Objective To investigate the clinical and pathological features of glomus tumor (GT) and its diagnostic and differential diagnosis. Methods One case of GT in the stomach was reported and histologically, immunohistochemically examined and reviewed for nearly 35 years. Results Stomach GT was mainly found in middle-aged women and developed in the antrum. The common symptoms were pain in the upper abdomen. The morphological features of the gastric GT were nodularity, consistent size of tumor cells, translucent or eosinophilic cytoplasm , Nuclear round, tumor cells arranged in solid or around the perivascular arrangement; immunohistochemical staining showed that the tumor cells vimen-tin, SMA, actin, calponin were (+), CK, CD117, Syn, S-100, EMA , Desmin, CD99, CD34 (-). Conclusion The clinical manifestations of gastric GT lack of specific symptoms, mainly for the pain of the upper abdomen, most of the biological behavior of benign, the most effective treatment is currently surgical resection. It has specific morphological features and immunophenotypes that need to be differentiated from other tumors, such as epithelial-like gastric stromal tumors and carcinoid tumors.