【摘 要】
：
患者男性,61岁.因进食哽噎感1个月、颈部疼痛不适1周,于2017年8月6日入院.患者1个月前进食时有哽噎感,尤以硬质食物明显,近2日吃流质食物也感吞咽不畅.1周前无明显诱因下感觉
【机 构】
：
沭阳人民医院 病理科 江苏沭阳 223600;沭阳人民医院 普外科,江苏沭阳 223600
论文部分内容阅读
患者男性,61岁.因进食哽噎感1个月、颈部疼痛不适1周,于2017年8月6日入院.患者1个月前进食时有哽噎感,尤以硬质食物明显,近2日吃流质食物也感吞咽不畅.1周前无明显诱因下感觉颈部疼痛不适,自认为“落枕”未行任何处理,疼痛一直未缓解,遂来医院就诊.颈部CT检查示C7椎体及附件多发骨质破坏伴棘突病理性骨折.MRI检查示C7椎体压缩变扁,椎体及棘突见T1WI低信号、T2WI等低信号、STIR高信号;周围软组织层次欠清并见软组织肿块(图1),硬膜囊前后缘略受累及,颈髓未见异常信号.胃镜检查,病理诊断为胃贲门部腺癌.患者行颈椎后路减压术,术中见颈7棘突、椎板两侧均被肿瘤侵犯破坏,手术切除颈7两侧椎板及肿瘤,病理检查巨检:碎骨组织共1. 5 cmxl. 5x1. 0 cm,胃镜活检组织3粒,大小0.2 cm.镜检:碎骨中见腺癌组织(图2);胃活检见中分化腺癌组织.经阅片比较,颈椎骨中腺癌与胃贲门部腺癌的组织学图像相一致.免疫组化:碎骨组织中腺癌细胞CK20(图3)和CEA(+),CK7( -).
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