21例胃肠道神经源肿瘤临床病理及免疫组化观察

Clinicopathologic and immunohistochemical observation of twentyone cases on neurogenic tumors of the gastricintestinal tract

目的：观察胃肠道神经源肿瘤的临床及病理形态学特点并探讨其组织发生。方法：对２１例胃肠道神经源肿瘤进行光镜观察，部分病例作组化及免疫组化染色。结果：２１例胃肠道神经源肿瘤中，发生于胃１４例、小肠６例、直肠１例。发病年龄３０～５０岁。镜下观察，良性神经鞘瘤１２例、神经纤维瘤４例、恶性神经鞘膜瘤４例、节细胞神经瘤１例。恶性神经鞘膜瘤４例中１例伴有横纹肌肉瘤分化，免疫组化染色Ｓ－１００弱阳性，Ｍｙｏｇｌｏｂｉｎ部分瘤细胞阳性，证实是恶性蝾螈瘤。结论：胃肠道良恶性神经源肿瘤病理特点和软组织的神经源肿瘤相似，具多向分化能力，可以含一种或数种异源性成分。

Purpose To investigate the clinicopathological characteristics and histogenesis of primary neurogenic tumors of the gastricintestinal tract. Methods Twentyone cases neurogenic tumors of the gastricintestinal tract were investigated at the light microscopic level and some cases were studied by histochemical and immunohistochemical techniques. Results The age of 21 cases with primary neurogenic tumors of the gastricintestinal ranged from 30 to 50 years. Among these cases, 14 were located in the stomach, 6 in the small intestine, one in the rectum. The histopathological features were as follows. Twelve cases of the schwanns tumors, 4 cases of neurofibroma, 4 cases of malignant schwannoma, and 1 cases of ganglioneuroma. One of the malignant schwannomas was stained by myoglobin and S100 protein with the immunoperoxidase, which proved itself malignant “triton” tumor. Conclusions The clinicopathological and histogenesis of benign or malignant neurogens tumors of the gastricintestinal tract is similar to those of soft tissue origin and may have one or more tissue components of heterologous mullenian.