3例胃窦部血管球瘤的临床病理特点并文献复习

Clinicopathologic features of gastric antral glomus tumor: 3 case reports and literature review

采用光镜及免疫组织化学(immunohistochemistry,IHC)的方法观察3例胃血管球瘤(glomus tumor,GT)的临床特点、病理形态特征及IHC表型,并进行文献复习,探讨胃GT的临床病理特征、诊断要点、鉴别诊断和治疗。胃GT属于罕见的良性间叶性肿瘤,其主要病理学特点为大量增生的血管或血窦周围可见肿瘤细胞,呈血管外皮瘤样结构或呈实性排列,被平滑肌束分隔。肿瘤细胞均阳性表达波形蛋白(Vimentin)和平滑肌蛋白(smooth muscle protein,SMA),血管内皮均阳性表达CD34,Ki-67阳性率均小于1%。该病需与胃肠间质瘤、胃神经内分泌肿瘤和副神经节瘤相鉴别。手术彻底切除肿瘤即可以治愈,可不予以放化疗。

The clinicopathological characteristics, microscopic and immunohistochemical characteristics, differential diagnosis and treatment of 3 cases with gastric glomus tumors were analyzed with follow-up period. Gastric glomus tumor is a rare benign interlobular tumor, the prominent pathological features included the tumor cells arranged around blood vessels or sinus showing a hemangiopericytoma-like pattern, some tumor cells in solid pattern. The tumors were separated by smooth muscle bundles. The tumor cells were positive for Vimentin, smooth muscle protein(SMA);CD34 and Ki-67 positive rates were all less 1%. Gastric glomus tumor needs to be differentiated from other tumors such as epithelioid stromal tumors in the gastrointestinal tract and carcinoid. Complete resection of tumor can be cured without radiotherapy or chemotherapy.