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目的探讨胃丛状血管黏液样肌纤维母细胞肿瘤(PAMT)的临床病理学特征及诊断、鉴别诊断要点。方法对2例胃丛状血管黏液样肌纤维母细胞肿瘤进行临床病理、免疫组化和电镜研究。结果临床表现为无症状或上腹部不适、疼痛。胃镜示肿物向胃腔内突出。镜下肿瘤在胃壁之间呈结节状、丛状生长,与胃壁平滑肌交错排列,肿瘤富于小的薄壁血管,细胞间富含黏液样或纤维黏液样基质;瘤细胞核呈梭形或卵圆形,核仁不明显,胞质轻度嗜酸性,细胞异型性不明显。免疫组化示肿瘤细胞SMA、MSA和h-caldesmon(+),个别细胞PR(+),CD117、CD34和S-100(-)。电镜示肿瘤有肌纤维母细胞分化。结论胃丛状血管黏液样肌纤维母细胞肿瘤是罕见的肿瘤,具有独特的形态特征,其诊断和鉴别诊断主要依靠病理组织学和免疫组化。
Objective To investigate the clinical and pathological characteristics of gastric mucinous myofibroblastic tumor (PAMT) and its diagnostic and differential diagnosis. Methods Two cases of gastric mucinous myofibroblastic tumor of gastric mucosa were studied by clinicopathological, immunohistochemical and electron microscopy. Results Clinical manifestations of asymptomatic or upper abdominal discomfort, pain. Gastroscopy showed tumor protruding to the stomach cavity. Microscopic tumor in the stomach between the nodular, plexiform growth, and the gastric smooth muscle staggered arrangement, the tumor is rich in small thin-walled vessels, cells rich in mucoid or fibrous myxoid-like matrix; tumor nuclei were fusiform or egg Round, nucleolus is not obvious, mild eosinophilic cytoplasm, cell atypia is not obvious. Immunohistochemistry showed tumor cells SMA, MSA and h-caldesmon (+), individual cells PR (+), CD117, CD34 and S-100 (-). Electron microscopy showed myofibroblastic tumor differentiation. Conclusion Gastric mucinous myofibroblastic tumor of the gastric mucosa is a rare tumor with unique morphological characteristics. The diagnosis and differential diagnosis mainly rely on histopathology and immunohistochemistry.