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目的探讨小肠憩室恶性间质瘤的影像学和临床病理学特征。方法对1例小肠憩室恶性间质瘤进行影像学、临床病理及免疫组化观察,并进行文献复习。结果患者男性,33岁。手术标本呈囊实性,与肠腔相通。组织形态镜下瘤细胞主要由梭形和少许上皮样细胞组成。梭形瘤细胞排列呈束状、编织状、栅栏状;上皮样瘤细胞呈小巢片状分布在梭形瘤细胞之间。免疫组化CD117、CD34、S-100、desmin、SMA和NSE均为(+)。结论胃肠间质瘤(GIST)可发生于从食管至肛门的胃肠道全长范围内,但是小肠憩室伴发恶性间质瘤十分罕见,临床症状无特殊规律性,极易误诊,诊断有赖于影像学、临床病理和最具特征的免疫组化检查。
Objective To investigate the imaging and clinicopathological features of small intestinal diverticula malignant stromal tumors. Methods One case of small intestinal diverticula malignant stromal tumors were studied by imaging, clinicopathology and immunohistochemistry, and the literature review. Results The patient was male, 33 years old. Surgical specimens were cystic, communicating with the intestine. Tissue morphology of tumor cells mainly by spindle and a small number of epithelial-like cells. Fusiform cells arranged in a bundle, braided, palisading; epithelioid tumor cells were small nest distribution between the spindle cells. Immunohistochemistry CD117, CD34, S-100, desmin, SMA and NSE were (+). Conclusions Gastrointestinal stromal tumors (GISTs) can occur in the entire length of the gastrointestinal tract from the esophagus to the anus. However, the intestinal diverticula with malignant stromal tumors are rare and have no special clinical symptoms. They are easily misdiagnosed and diagnosed In imaging, clinical pathology and the most characteristic immunohistochemical examination.