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目的探讨胃巨细胞血管纤维瘤(GCA)的临床病理特征及其鉴别诊断。方法对1例胃GCA进行胃镜、组织学观察及免疫组化染色,结合文献讨论其临床病理特点及鉴别诊断。结果患者女性,49岁,上腹部不适半年。胃镜示胃体下部后壁见一约3 cm×3 cm带蒂息肉,表面糜烂。手术切除肿块。镜下示肿瘤位于胃黏膜下层,瘤细胞呈小叶状排列,疏密相间,瘤细胞卵圆形或短梭形,并见大量多核巨细胞,巨细胞核大、深染,核型不规则,未见明显分裂象。肿瘤内血管丰富,并含有少量内衬不连续的巨细胞的假血管样腔隙。免疫组化示vimentin、CD34、CD99均(+),bcl-2部分(+)。结论本例是首次发生于胃的GCA病例报道。GCA是一种好发于成年人眼眶区,亦可发生眶区以外的良性或低度恶性潜能肿瘤,诊断与鉴别诊断主要依靠病理组织学及免疫组化,局部完整切除后较少复发,需密切随访。
Objective To investigate the clinicopathological features and differential diagnosis of gastric giant cell angiofibroma (GCA). Methods Gastric endoscopy, histological observation and immunohistochemical staining of gastric GCA were performed in one patient. The clinical and pathological features and differential diagnosis of GCA were discussed. Results Female patients, 49 years old, upper abdominal discomfort for six months. Gastroscopy shows the lower part of the corpus see a ca. 3 cm × 3 cm pedunculated polyps, surface erosion. Surgical removal of lumps. Microscope showed tumor located in the gastric mucosa, the tumor cells showed lobular arrangement, density and phase, tumor cells oval or short fusiform, and see a large number of multinucleated giant cells, giant cell nuclei, deep staining, karyotype irregular, not See obvious divisions. Tumor blood vessels rich, and contains a small amount of non-continuous lined giant cells of the pseudo-vascular-like space. Immunohistochemistry showed vimentin, CD34, CD99 were (+), bcl-2 part (+). Conclusion This is the first case of GCA in the stomach. GCA is a kind of benign or low malignant tumor that occurs in the orbital area of adults and may also occur outside the orbital area. The diagnosis and differential diagnosis mainly rely on histopathology and immunohistochemistry. Close follow-up.