摘要
目的探讨胃血管球瘤的临床病理特征、诊断和鉴别诊断。方法对4例胃血管球瘤行组织学观察和免疫组织化学分析,并复习相关文献。结果肿物位于胃窦或胃体黏膜下,直径1.5~3 cm。显微镜下肿瘤组织在胃肌壁间呈多结节状分布;结节内肿瘤细胞小-中等大小,圆形、多角形,胞界清楚,胞质丰富红染或空亮,细胞核圆形、卵圆形居中,无明显异型性到轻度异型,核分裂像罕见;瘤组织内富含血管,部分瘤细胞围绕分枝状的血管形成血管外皮瘤样结构;部分瘤细胞呈实性分布。免疫组织化学肿瘤细胞vimentin、平滑肌肌动蛋白（smooth muscle antigen,SMA）、actin及层粘连蛋白（laminin,LN）阳性;CK、CD34、CD117、DOG-1、CgA、Syn、S-100、HMB45、Melan-A等阴性。结论胃血管球瘤非常少见,大多数生物学行为表现为良性。确诊需结合组织病理学形态和免疫表型综合分析,需与胃肠间质瘤及神经内分泌肿瘤等鉴别。
Objective To investigate the clinicopathological features,diagnosis and differential diagnosis of gastric glomus tumor.Methods Morphological features of 4 cases of gastric glomus tumor were observed by light microscopy and immunohistochemistry with review of the related articles.Results The tumor appeared in submucosal nodules in the body or corpus of the stomach,with 1.5-3 cm in diameter.Microscopically,the tumors distributed among the smooth muscle bundles in a multinodular pattern.Tumor cells were small to middle-sized,round or polygonal,which had clear or eosinophilic cytoplasm.The nucleus were round or oval with no or slight atypia.Mitotic figures are rare.The tumor were rich in blood vessles.Some tumor cells arranged around vessles or sinus showing a hemangiopericytoma-like pattern,some tumor cells grew in a solid pattern.Immunohistochemical staining showed tumor cells were positive for vimentin、SMA、actin and laminin,but negative for CK、CD34、CD117、DOG-1、CgA、Syn、S-100、HMB45 and Melan-A.Conclusions Gastric glomus tumor is extremelly rare and mostly benign.Diagnosis mainly relied on pathological morphology and immunophenotype.Differential diagnosis from gastrointestinal stromal tumor and neuroendocrine tumors is recommended.
出处
《华南国防医学杂志》
CAS
2014年第11期1080-1083,共4页
Military Medical Journal of South China
关键词
胃
血管球瘤
免疫组织化学
诊断
鉴别
Gastric
Glomus tumor
Immunohistochemistry
Diagnosis
Differential
