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目的探讨发生在小肠、具有旋涡状结构的恶性胃肠间质瘤(GIST)的临床病理特征、分子生物学及电镜特点。方法对1例具有脑膜瘤样特征的GIST进行临床病理学分析研究,行常规病理检查、免疫组化、电镜观察及PCR扩增和DNA测序检测。结果镜检示瘤细胞似“脑膜瘤”样排列,细胞质丰富,核梭形,核分裂象易见。免疫组化示瘤细胞CD117(+);PCR产物直接测序显示c-kit基因外显子均无突变;电镜示瘤细胞间可见桥粒连接。结论 GIST形态学上具有“脑膜瘤”样结构特征,免疫组化具有经典GIST的特征,电镜检测有助于确定诊断。
Objective To investigate the clinicopathological features, molecular biology and electron microscopic features of malignant gastrointestinal stromal tumors (GIST) in the small intestine and swirling structures. Methods One case of GIST with meningioma-like features was studied by clinicopathological analysis, routine pathological examination, immunohistochemistry, electron microscopy, PCR amplification and DNA sequencing. The results of microscopic examination of tumor cells like “meningioma ” like arrangement, rich cytoplasm, nuclear fusiform, mitotic easy to see. Immunohistochemistry showed that tumor cells CD117 (+); direct sequencing of PCR products showed no mutation in c-kit exon; electron microscopy showed desmosomal connections between tumor cells. Conclusions The morphology of GIST is characterized by “meningioma” -like structure. Immunohistochemistry has the characteristics of classic GIST. Electron microscopy can be helpful to confirm the diagnosis.