小肠胃肠道间质瘤DSA表现与病理分析

The Angiographic findings and Pathology Analysis of Small Bowel Gastrointestinal Stromal Tumor

目的:探讨小肠胃肠道间质瘤血管造影(DSA)表现与病理特点。材料与方法:回顾性分析11例小肠胃肠道间质瘤血管造影资料,并与病理学和免疫组织化学结果做对照。结果:肿瘤发生于空肠6例,回肠5例,其中良性6例,潜在恶性2例,恶性3例。DSA造影表现11例肿瘤供血动脉增粗,2例可见静脉提前显影。良性肿瘤周围血管呈抱球状;恶性间质瘤:可见异常血管、呈乱发状,失去正常的血管分布规则,周围部分血管边缘模糊。病理及免疫组化:肿瘤多为梭形和上皮细胞,CD117(+)100%,CD34(+)72.7%。结论:小肠间质瘤的血管造影征象具有一定的特征性,DSA定位较准确,对肿块诊断及良恶性的鉴别诊断有一定的帮助。

Purpose：The purpose of this study was to evaluate the angiographic findings of small bowel gastrointestinal stromal tumor（GIST）with pathology diagnosis.Materials and Methods：The clinical and angiographic findings of 11 patients with surgically and pathologically diagnosis of small bowel GISTs were retrospectively analyzed.Results：The tumors originated from the jejunum（n=6）and ileum（n=5）.there were 6 cases of benign stromal tumor,2 cases of borderline stromal tumor,and 3 cases of malignant stromal tumor.Obviously thickened supplying arteries were detected in 11 tumors,and early-developed veins were found in 2.Two types of angiographic changes of small bowel GIST were observed.Three cases had twisted irregular neoplastic vessels with partially coarse and indistinct margins,which were all malignant.Eight cases had ball-like neoplastic vessels with uniform tumor staining,of which 6 were benign and 2 was malignant.Histopathological examination indicated that the tumor consisted of spindle cells and epithelial cells.Immunohistochemical analysis revealed that the positive staining was 100% for CD 117 protein and 72.7% for CD 34.Conclusion：Characteristic angiographic findings could be revealed in small bowel GIST,the tumor could be accurately localized and DSA is helpful in the diagnosis and differential diagnosis for the benign and malignant tumors.The final diagnosis of small bowel GISTs depended on histopathological and immunohistochemical examination.