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目的探讨胃丛状纤维黏液瘤(PF)的临床病理特征及其鉴别诊断。方法对1例胃PF进行胃镜、组织学观察及免疫组化染色,结合文献讨论其临床病理特点及鉴别诊断。结果患者男性,64岁。左上腹部不适1月余。胃镜示胃窦小弯后壁黏膜下肿物,3.3 cm×2.5 cm大小,边界清晰,表面光滑,色泽正常,顶部凹陷。手术切除肿块。镜下见肿瘤呈多结节状生长,与胃壁平滑肌组织交错分布,富含小的薄壁血管和黏液样基质。肿瘤细胞呈梭形或卵圆形,异型性不明显,未见核分裂象。免疫组化示肿瘤细胞SMA弱(+),CD34、S-100、desmin、CD117和Dog-1(-)。结论胃丛状纤维黏液瘤是一种罕见的有独特组织学特征的胃间叶性肿瘤,熟悉其临床病理学特征有助于与其他胃肠间叶源性肿瘤相鉴别。
Objective To investigate the clinicopathological features and differential diagnosis of gastric plexus myxoma (PF). Methods Gastroscopy, histological observation and immunohistochemical staining of 1 case of gastric PF were studied. The clinical and pathological features and differential diagnosis were also discussed. Results The patient was male, 64 years old. Left upper abdominal discomfort more than 1 month. Gastroscopy showed a small benign gastric mucosa, 3.3 cm × 2.5 cm size, clear boundary, smooth surface, normal color, the top of the depression. Surgical removal of lumps. Microscopically, the tumor showed multiple nodular growths, which were staggered with the smooth muscle tissue of the stomach wall and were rich in small thin-walled blood vessels and myxoid-like matrix. Tumor cells were spindle or oval, atypia was not obvious, no mitotic phenomenon. Immunohistochemistry showed weak SMA cells (+), CD34, S-100, desmin, CD117 and Dog-1 (-). Conclusion Gastric plexus myxomatous is a rare gastrocytic tumor with unique histological features. Being familiar with its clinicopathological features can be helpful in differentiating other gastrointestinal mesenchymal tumors.