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目的探讨胃血管球瘤的临床病理学、免疫组化和生物学行为特点。方法观察5例胃血管球瘤的临床表现,病理形态特征及免疫组化表型,并复习文献,探讨其生物学行为特征。免疫组化采用SP法。检测用抗体包括vimentin、actin、a-SMA、MSA、CD117、CD34、CK、Syn、CgA、LCA、desmin、CD99、S-100、EMA和Ki-67。结果 5例患者中,男性1例,女性4例,平均年龄42岁(34～65岁)。常见症状为上腹部疼痛。肿物直径为0.8～5 cm(平均为2.4 cm)。巨检:肿物界清、无包膜,切面灰白色,质实。镜检:肿瘤组织呈结节分叶状,被平滑肌细胞分隔包绕。肿瘤细胞大小一致,呈圆形或卵圆形,围绕薄壁的血管或血窦周围排列,呈血管外皮瘤样或实性巢团状,瘤细胞核圆形,可见核仁,未见核异型性,核分裂象罕见(0～3个/50 HPF),未见病理核分裂象。1例瘤体直径5 cm者瘤细胞较密集,有局灶异型,核分裂象(1个/50 HPF),诊断为恶性潜能未定肿瘤。免疫组化:vimentin、actin、a-SMA和MSA均(+),余CD117、CD34、CK、Syn、CgA、LCA、desmin、CD99、S-100和EMA均(-),Ki-67阳性率<2%。5例均行胃肿块切除。随访8个月至5年,未见复发或转移。结论胃血管球瘤绝大多数为良性肿瘤,与软组织血管球瘤比较,具有自身病理形态学及生物学行为的特征。
Objective To investigate the clinicopathological, immunohistochemical and biological behavior of gastric gliomas. Methods The clinical manifestations, pathological features and immunohistochemical phenotypes of 5 cases of gastric gliomas were observed. The literature was reviewed to discuss their biological behavior. Immunohistochemistry SP method. Antibodies for detection include vimentin, actin, a-SMA, MSA, CD117, CD34, CK, Syn, CgA, LCA, desmin, CD99, S-100, EMA and Ki-67. Results Among the 5 patients, 1 was male and 4 was female, with an average age of 42 years (34-65 years). Common symptoms of upper abdominal pain. The tumor diameter 0.8 ~ 5 cm (average 2.4 cm). Jujian: Mass clearance, no capsule, cut white, quality. Microscopic examination: tumor tissue was lobulated, separated by smooth muscle cells. Tumor cells of the same size, were round or oval, arranged around the thin-walled blood vessels or sinusoids, vascular endothelial tumor-like or solid nest mass, round nucleoli, visible nucleoli, no nuclear atypia , Mitosis as rare (0 to 3/50 HPF), no pathological mitosis. One tumor with a diameter of 5 cm had dense tumor cells with focal heteromorphosis and mitosis (1/50 HPF). The tumor was diagnosed as malignant potential undetermined tumor. Immunohistochemistry showed that the positive rate of Ki-67 in both vimentin, actin, a-SMA and MSA were (+), and the positive rates of CD117, CD34, CK, Syn, CgA, LCA, desmin, CD99, <2%. 5 patients underwent resection of the stomach mass. Follow-up 8 months to 5 years, no recurrence or metastasis. Conclusion The majority of gastric gliomas are benign tumors, which are characterized by their own pathomorphology and biological behavior compared with soft-tissue glomus tumors.