论文部分内容阅读
目的探讨胃血管球瘤的病理学特征以及鉴别诊断。方法对8例手术切除的胃血管球瘤进行临床资料分析、组织形态学观察和免疫组化检测,并结合文献进行讨论。结果 8例患者中男女各为4例,半数有右上腹痛症状。肿瘤均位于胃窦黏膜下,最大直径1.5～3.5 cm,界限清楚。光镜下表现为大小一致、边界清楚的小圆形肿瘤,肿瘤细胞围绕血管排列,细胞核圆形,染色质细腻。7例无细胞异型,未见核分裂;1例细胞轻度异型,核分裂2个/50 HPF。该例经半年随访未见复发。8例肿瘤细胞vimentin和SMA(+),其中1例Dog-1呈弱(+),2例CD34呈局灶(+);AE1/AE3、NSE、chromogranin A、CD56、synaptophysin和CD117均呈(-)。结论胃血管球瘤是胃少见肿瘤,应注意与胃肠间质肿瘤、胃类癌、胃副节瘤和胃血管外皮瘤相鉴别,免疫组化有助于鉴别诊断。胃血管球瘤绝大多数为良性,恶性或高风险胃血管球瘤的评估需要综合肿瘤大小、细胞异型性、核分裂活性和有/无病理性核分裂等多项指标。
Objective To investigate the pathological features and differential diagnosis of gastric gliomas. Methods Clinical data analysis, histomorphological observation and immunohistochemistry were performed on 8 cases of gastric resected gastric gliomas, and the literature was discussed. Results Eight patients were male and 4 female, and half had right upper quadrant pain symptoms. Tumors were located in the gastric mucosa, the largest diameter of 1.5 ~ 3.5 cm, clear boundaries. Light microscopy showed the same size, clear border of small round tumors, tumor cells arranged around the blood vessels, the nucleus was round, fine chromatin. Seven cases were atrophic and had no nuclear fission. One case had mild dysmorphic, mitotic 2/50 HPF. The case no recurrence after six months of follow-up. 8 cases of tumor cells vimentin and SMA (+), 1 case of Dog-1 was weak (+), 2 cases of CD34 were focal (+); AE1 / AE3, NSE, chromogranin A, CD56, synaptophysin and CD117 were -). Conclusion Gastric glioma is a rare tumor in the stomach. It should be distinguished from gastrointestinal stromal tumors, gastric carcinomas, gastric parathyroid and gastric hemangiopericytoma. Immunohistochemistry is helpful for the differential diagnosis. The vast majority of gastric angiomas are benign, malignant, or at risk for the assessment of gastric gliomas that require a combination of multiple indicators of tumor size, cellular atypia, mitotic activity, and / or pathological mitosis.