摘要
目的探讨消化道及腹腔神经鞘瘤临床病理、免疫组化特点及其与胃肠道间质瘤（GIST）鉴别要点。方法回顾性分析8例消化道及腹腔神经鞘瘤的临床病理特点，并检测S-100蛋白、CD117、PDGFRA等抗体在该肿瘤的表达情况。结果男性3例、女性5例，年龄23-64岁（平均47岁）。肿瘤位于消化道4例：均无包膜，与周围组织分界较清，瘤细胞呈梭形。排列呈席纹状、片状或小束状，3例见瘤旁淋巴细胞套形成。肿瘤位于腹腔4例：3例有包膜，瘤细胞呈梭形，2例见局灶性上皮样细胞、2例见栅栏状结构及黄瘤样细胞、3例见血管壁玻变。S-100蛋白阳性率为100％（8／8），PDGFRA阳性率为37．5％（3／8），而CD117、CD34、SMA及Desmin均为阴性表达。结论消化道及腹腔神经鞘瘤少见，形态学上消化道神经鞘瘤有别于腹腔神经鞘瘤，免疫表型上均强表达S-100蛋白。
Objectire To analyze clinicopathological and immunohistochemical features about schwannoma in digest tract and abdominal cavity and to identify diagnosis with gastrointestinal stromal tumor （GIST）. Methods 8 patients with schwannoma in digest tract and abdominal cavity were retrospectively analyzed, and the tumors were examined by a panel of antibodies including S-100, CD34, SMA, Desmin and PDGFRA. Results The patients were 3 men and 5women, whose ages ranged from 23 to 64 years （median 47 years）. 4 cases which tumors are located in digest tract were not encapsulated with clear boundary. Microscopically, these tumors were composed of spindle cells and mainly formed storform, sheets and small clusters; Peripheral cuff-like lymphoid aggregates were detected in 3 cases. Among 4 cases located in abdominal cavity, 3 cases were encapsulated, and all tumors were composed of spindle cells with focal epithelioid cell in 2 cases, palisade pattern in 2 cases, xanthoma cells in 2 cases, the vascular wall hyalinization in 3 cases respectively. Immunohistochemically, tumors were strongly positive for S-100 protein （100%, 8/8） and variably positive for PDGFRA （37. 5%, 3/ 8）, but all were negative for CDll7, CD34, SMA Desmin. Conclusion The Schwannomas are rare in digest tract and abdominal cavity. Morphologically, the tumors occurred in digest tract are different from that occurred in abdominal cavity. Immunohistochemically, the tumors are strongly positive for S-100 protein.
出处
《贵州医药》
CAS
2008年第3期200-202,共3页
Guizhou Medical Journal
基金
贵州省科委基金项目[黔基合计字(2003)3031号]
贵州省长基金项目[黔省专合字(2005)163号]
关键词
神经鞘瘤
消化道
腹腔
临床病理
Schwannoma Digest tract Abdominal cavity Clinicopathology
