胃反应性结节状纤维性假瘤误诊为胃恶性肿瘤案例并文献复习

Reactive nodular fibrous pseudotumor of the stomach misdiagnose as gastric carcinoma report and review of literature

目的总结胃反应性结节状纤维性假瘤(reactive nodular fibrous pseudotumor,RNFPT)的临床病理特征,提升临床对该病的了解和术前诊断率,防止临床上的误诊及过度医疗。方法结合赣南医学院第一附属医院收治的1例RNFPT,通过文献复习,分析相应临床病理等特征。结果胃RNFPT的病理特征为,杂乱排列的梭形或星状细胞,边界清楚,伴瘢痕样粗大胶原纤维,伴黏液变性或玻璃样变性。结论胃RNFPT为一种罕见的由炎症刺激或腹腔手术所致的纤维性炎性病变,由于没有特异性的影像表现,易与胃恶性肿瘤相混淆。因此,术中应尽量行快速冰冻切片,以防止误诊和过度治疗。

Objective To analyze the clinicopathoiogic characteristics of gastric reactive nodular fibrous pseudotumor(RNFPT),to improve the understanding and preoperative diagnosis of the disease,and to prevent misdiagnose and clinical over-medication.Method Combined with a case of RNFPT admitted to the First Affiliated Hospital of Gannan Medical College,the clinical and pathological characteristics were analyzed through literature review.Result The pathological features of RNFPT is the tumors appear as a disorderly arrangement of fusiform or stellate cells,with clear boundaries,with keloid-like coarse collagen fibers,and with mucoid degeneration or hyaline degeneration.Conclusion Gastric RNFPT is considered to be a rare fibrotic inflammatory lesion caused by inflammatory stimuli or abdominal surgery.it is easy to be confused with gastric carcinoma,as there is no specific imaging manifestation.So it is very necessary to perform intraoperative rapid frozen section for preventing misdiagnosis and clinical over-medication.