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消化系统颗粒细胞瘤在临床上非常少见,是一种来源于黏膜下层、具有雪旺细胞分化特征的神经源性肿瘤,生长缓慢,一般为孤立性结节,形态不规则,显微镜下瘤细胞呈巢状及索状排列,免疫组化显示神经特异性标记S-100蛋白表达阳性,恶性瘤细胞显著异型性。消化系统颗粒细胞瘤多无临床症状,常在内镜检查时发现,表现为灰白色或淡黄色黏膜下半球形结节,表面光滑,内镜下深挖或大块活检可提高病理诊断的准确率,超声内镜检查可显示肿瘤起源层次及扩散范围。通常认为有无转移、手术切除后是否复发是良恶性颗粒细胞瘤鉴别的主要标准。对直径<20mm的颗粒细胞瘤,首选内镜下局部微创切除治疗,对多发或来源于肌层的颗粒细胞瘤及恶性颗粒细胞瘤主要治疗手段为手术切除,放、化疗目前研究很少。消化系统颗粒细胞瘤治疗后复发率较高,恶性颗粒细胞瘤术后局部复发率达32%～59%,并可发生远处转移,广泛转移是致死的主要原因。
Digestive system granulosa cell tumor is very rare clinical, is a derived from the submucosa, with Schwann cell differentiation characteristics of neurogenic tumors, slow growth, usually isolated nodules, irregular shape, microscopic tumor cells were Nests and cord-like arrangement, immunohistochemistry showed that the nerve-specific marker S-100 protein expression was positive, atypical malignant tumor cells. Most of the digestive system granulosa cell tumor without clinical symptoms, often found in endoscopy, manifested as gray or light yellow submucosal nodules, smooth surface, deep endoscopic or large biopsy can improve the accuracy of pathological diagnosis Ultrasound endoscopy can show the level of tumor origin and spread of the scope. It is generally considered that there is no metastasis, recurrence after resection is the main criteria for benign and malignant granular cell tumor. Of the diameter of <20mm of granular cell tumor, the preferred endoscopic minimally invasive resection of the local treatment of multiple or from the myomegaly and malignant granular cell tumor of the main treatment for surgical resection, radiotherapy and chemotherapy are few studies. After the treatment of digestive system granulosa cell tumor recurrence rate is high, the local recurrence rate of malignant granular cell tumor is 32% -59%, and distant metastasis may occur, the extensive transfer is the main cause of death.