胃血管球瘤3例临床病理观察

The clinicopathological study of gastric glomus tumor in 3 cases

目的：探讨胃血管球瘤的临床病理学特征、诊断、鉴别诊断和生物学行为。方法：观察3例胃血管球瘤的临床资料,进行组织形态和免疫组织化学法观察,并结合文献进行讨论。结果：3例患者术前均被诊断为胃肠间质瘤,术后病理诊断为胃血管球瘤。肿瘤组织呈结节分叶状,被平滑肌细胞分隔包绕。肿瘤细胞大小一致,圆形或卵圆形,围绕血管排列。细胞核圆形,可见核仁,核异型性不明显,核分裂象罕见。免疫组织化学法：Vimentin、SMA、Calponin均为阳性,Cg A、NSE、AE1/AE3、CD117、CD34、LCA、Desmin、CD99、S-100均为阴性。随访时间2-4年,患者术后均未见复发。结论：胃血管球瘤非常少见,具有特定的形态学特征和免疫表型,易误诊,需要和其他肿瘤鉴别。

Objective：To explore the clinicopathological characteristics,diagnosis,differential diagnosis and biological behavior of gastric glomus tumor. Methods：The histological manifestations and immunohistochemical results in 3 gastric glomus tumors were analyzed,and the relevant literature was reviewed. Results：All cases were preoperatively diagnosed as gastrointestinal stromal tumor, and the postoperative pathological diagnosis of which was gastric glomus tumor. Tumor tissue was lobulated node, and separated and enveloped by smooth muscle cells. The tumor cells were uniform-sized,round or oval,arranging around the blood vessels. Tumor nuclei were round with visible nucleoli,no nuclear atypia and rare mitoses. The immunohistochemical staining showed that the vimentin,SMA and calponin were positive,and CgA,NSE,AE1/AE3,CD117,CD34,LCA,desmin,CD99 and S-100 were negative. The recurrence in 3 cases of gastric glomus tumor were not found during the 2 to 4 years of following up. Conclusions：Gastric glomus tumor is rare,which has the distinct morphological and immunohistochemical features,can be easily misdiagnosed.