伴淋巴结转移的胃肠间质瘤2例临床病理观察

Gastrointestinal stromal tumors associated with lymph node metastasis:a clinicopathological study of 2 cases

目的探讨伴淋巴结转移的胃肠间质瘤(GIST)的临床病理特征。方法对2例伴淋巴结转移的胃肠间质瘤进行形态学观察及免疫组化标记,结合临床资料并复习相关文献。结果 2例胃肠间质瘤分别发生于小肠和结肠。肉眼观察肿瘤均为黏膜下结节状肿物,体积较大,质地细腻,鱼肉状;镜下肿瘤组织由梭形细胞和上皮样细胞混合构成,核分裂象>10个/50HPF,均出现大片坏死。免疫组化示CD117均(+)。结论伴淋巴结转移的胃肠间质瘤非常少见,核分裂象高与坏死可能为其主要组织学特征。

Objective To study the clinicopathologic features of gastrointestinal stromal tumors（GISTs） with lymph node metastasis.Methods Two cases of GIST associated with lymph node metastasis were collected and investigated by light microscopy and immunohistochemistry with review of clinical data and correlated literature.Results The tumors were situated in small intestine and colon as a mass of irregular shape below the mucosa.Histologically,the tumors consisted of epithelioid and spindled cells,with areas of necrosis.The mitotic count measured 21 and 6 per 50 high power fields.Immunohistochemical results showed the tumor cells expressed CD117.Conclusion GIST with nodal metastasis is very rare and the high mitotic count and necrosis may be their principal histopathological features.