摘要
目的:探讨胃神经鞘瘤(gastric schwannoma)的临床病理学特点、免疫表型、诊断及鉴别诊断。方法:对8例胃神经鞘瘤的临床特点、组织形态学和免疫组织化学结果进行分析,并复习相关文献。结果:患者女性5例,男性3例,平均年龄61岁(30~81岁)。8例胃神经鞘瘤直径1.0~7.0 cm(平均3.0 cm),无包膜,切面灰白色,镜下,瘤细胞短梭形,束状、栅栏状排列,肿瘤的边缘见淋巴细胞套。免疫组织化学染色:S-100全阳性,胶质纤维酸性蛋白(glial fibrillary acidic protein,GFAP)7例阳性,CD117、CD34、Dog1、a-平滑肌肌动蛋白(a-Smooth muscle actin,a-SMA)、结蛋白(Desmin)阴性。3例发现血小板衍化生长因子受体(platelet-derived growth factor receptor,PDGFR)阳性,但未发现c-kit和PDGFRα的基因突变。结论:胃神经鞘瘤是一种良性肿瘤,需与胃肠道间质瘤鉴别。
Objective:To determine the clinicopathologic feature,immunohistochemistry,diagnosis and differential diagnosis of gastric schwannoma.Methods:Clinical characteristics,pathological morphology and immunohistochemical staining in 8 cases of gastric schwannoma were analyzed,and literature was reviewed.Results:The patients included 5 females and 3 males.The age of patients ranged from 30 to 81 years(median=61 years).The size of the tumors ranged from 1.0 to 7.0 cm in diameter(median=3.0 cm).Gross examination showed that gastric schwannoma was white and without true fibrous capsule.The tumors were composed entirely or mainly of short spindle shaped cells which were described in a palisade manner or in bundles.All tumors showed a lymphocytic cuffing at the peripheral part.Immunohistochemistry results showed,the expression of S-100 was all positive,and glial fibrillary acidic protein(GFAP) was positive in 7 cases while CD117,CD34,Dog1,a-Smooth muscle actin (a-SMA) and Desmin were negative.Three cases showed positivity for PDGFR,but with no mutations found in c-kit and platelet-derived growth factor receptor α(PDGFRα).Conclusion:Gastric schwannoma is a benign tumor and should be differentially diagnosed from the gastrointestinal stromal tumor.
出处
《临床与病理杂志》
CAS
2014年第4期415-419,共5页
Journal of Clinical and Pathological Research
基金
南京医科大学科技发展基金重点项目(2012NJMU084)~~
关键词
胃神经鞘瘤
免疫组织化学
鉴别诊断
gastric schwannoma
immunohistochemistry
differential diagnosis