2例胃粘膜下炎症性肌纤维母细胞瘤临床病理分析

目的探讨分析发生于胃粘膜下的炎症性肌纤维母细胞瘤(IMT)的临床与病理特点及鉴别诊断要点。方法分析2例胃粘膜下IMT的临床和病理特点,并进行免疫组化检测。结果 2例IMT中男性1例,女性1例,年龄分别为84岁、19岁。肿块均位于胃窦部粘膜下。组织学主要表现为梭形细胞肿瘤,主要为纤维母细胞与肌纤维母细胞,二者混杂排列,呈束状、编织状,间质为大量炎症细胞。肿瘤细胞vimentin均(+),1例SMA(+),1例desmin(+),而CD117、CD34、S-100均(-)。结论胃粘膜下IMT是比较少见的良性肿瘤,但少数具有复发倾向及恶变潜能,主要由梭形细胞和炎症细胞组成,需与梭形细胞肿瘤鉴别。

Objective To study the clinicopathologic characteristics and differential diagnosis of inflammatory myofibroblastic tumor（ IMT） of submucosa of stomach. Methods 2 cases of IMT were analyzed by light microscopy and immunohistochemistry. Results Tumors from 1 male and 1 female were both found in the submucosa of stomach. Histologically,the tumors were composed of spindle cells which were principally characterisized by mixed arrangement of fibroblast and myofibroblast,infiltration of inflammatory cells in the stroma. The neoplastic cells were positive for vimentin,SMA（ 1 /2） ,desmin（ 1 /2） ,and negative for CD117,CD34 and S-100. Conclusions Most of IMT of submucosa of stomach are rare benign cases and characterized microscopically by the proliferation of a spindle cell component against a heavy inflammatory infiltrate,a few cases have malignant potential. More attention should be paid to differentiate it from the tumors of spindle cells similar to IMT.