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目的探讨罕见的皮革样胃肥大细胞增生症的临床病理特点。方法报道1例皮革样胃肥大细胞增生症,回顾分析其临床表现、影像学、胃镜下表现及病理组织学特点,应用免疫组化方法及特殊染色进一步确认诊断,探讨诊断及鉴别诊断,同时随访患者。结果临床无特殊表现。影像学显示胃底后壁明显弥漫性均匀增厚。胃镜显示黏膜粗大。病理检查大体示胃呈皮革样改变;镜下胃壁全层见肥大细胞弥漫浸润并部分累及局部淋巴结。免疫组化示肿瘤细胞CD117、CD43、CD68和LCA(+);甲苯胺兰染色示瘤细胞胞质呈紫红色。随诊44个月,患者健康。结论胃肥大细胞增生症是罕见的系统性肥大细胞增生,胃呈皮革样改变和惰性生长是其特殊之处。
Objective To investigate the clinicopathological features of rare leather-like gastric mastocytosis. Methods A case of leather-like gastric mastocytosis was reported. The clinical manifestations, imaging, endoscopic findings and histopathological features were retrospectively analyzed. Immunohistochemical methods and special staining were used to further confirm the diagnosis, discuss the diagnosis and differential diagnosis, and follow-up. patient. Results No clinical manifestations. Imaging revealed a diffuse, uniform thickening of the fundal posterior wall. Gastroscopy shows that the mucosa is thick. Pathological examination generally showed a leather-like change in the stomach; the full layer of the stomach wall showed diffuse infiltration of mast cells and partial involvement of regional lymph nodes. Immunohistochemistry showed tumor cells CD117, CD43, CD68, and LCA (+); toluidine blue staining showed the cytoplasm of the tumor cells was purple. Follow-up for 44 months, the patient was healthy. Conclusions Gastric mastocytosis is a rare systemic mast cell hyperplasia. The appearance of leathery changes and inert growth in the stomach is a special feature.