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患者男,56岁,因上腹胀满2个月在我院行电子胃镜检查。食管下端齿状线上约0.5cm见一0.5cm×0.7cm大小丘状黏膜内肿物,淡黄色,表面光滑,质实,随黏膜轻度活动(图1)。胃镜诊断:食管黏膜内肿物性质待查。内镜超声检查发现病变化位于黏膜层,呈低回声结节,约0.4cm×0.6cm,边界清,内部回声均匀(图2),诊断为食管黏膜层低回声结节性质待定,颗粒细胞瘤可能性大。胃镜下将食管肿物圈套切除,术后无明显并发症。切除组织为黏膜深层0.4cm×0.6cm大小肿物,淡黄色,质地中等硬度。镜下细胞呈圆形、类圆形,胞体较大,胞浆丰富,充满分布均匀的嗜酸性颗粒,核小居中,大小一致,深染。免疫组织化学染色:S100(+),Vimentin(+),Ⅷ(-),Desmin(-),CK(-),病理诊断:食管颗粒细胞瘤。
The patient was a 56-year-old man who underwent electronic gastroscopy at our institution for having had his upper abdominal fullness for 2 months. About 0.5cm at the lower dentate line of the esophagus, a 0.5cm×0.7cm mound-like intramucosal mass was seen, which was light yellow, and the surface was smooth and of good quality. Mild activity was observed with the mucosa (Fig. 1). Endoscopy diagnosis: The nature of esophageal mucosal tumors remains to be investigated. Endoscopic ultrasonography revealed that the disease was located in the mucosal layer, with hypoechoic nodules, approximately 0.4 cm x 0.6 cm, clear borders, and uniform internal echo (Figure 2). The diagnosis was that the hypoechoic nodules in the esophageal mucosa were undetermined, with granular cell tumors. Possibly great. Endoscopic resection of esophageal masses was performed under gastroscope without postoperative complications. The resection tissue was a 0.4cm×0.6cm mass with deep mucous membrane, pale yellow, and medium texture. Microscopically, the cells were round and round, with large cell bodies, abundant cytoplasm, and full of eosinophilic particles with uniform distribution. Immunohistochemical staining: S100 (+), Vimentin (+), VIII (-), Desmin (-), CK (-), pathological diagnosis: esophageal granulosa cell tumor.