胃血管球瘤临床病理学特征分析

Clinicopathologic features of gastric glomus tumor

目的分析原发于胃的血管球瘤的临床病理学特征,并与原发于胃的其他组织学形态相似的肿瘤进行鉴别诊断,进一步提高对胃血管球瘤的认识。方法对我科收集的22例原发于胃的血管球瘤的临床特征、病理形态学及免疫组织化学特征进行观察和分析。结果22例胃血管球瘤病例中男性12例,女性10例;年龄最大者66岁,最小者25岁,平均年龄50.18岁;肿瘤位于胃体部6例,位于胃窦部14例,位于窦体交界部2例;本组肿瘤直径最大8.0 cm,最小0.9 cm,平均直径2.7 cm;病理形态学方面,本组肿瘤细胞形态以小圆及短梭形细胞为主(20/22),部分肿瘤细胞形态表现为梭形(2/22),本组22例肿瘤结节内均未见明确肿瘤性坏死,平均核分裂象计数2个/10HPF;其中3例肿瘤出现细胞密度增大、肿瘤与神经、血管关系密切,具有恶性潜能的特征;免疫组化方面,本组肿瘤细胞均表达SMA(22/22),大部分肿瘤细胞表达神经内分泌标记物Syn(15/18),少数病例表达CD34(3/22),本组肿瘤细胞平均Ki-67指数为5%,所有病例肿瘤细胞均不表达CD56、CK、S-100、CD117、DOG-1。结论胃血管球瘤是一种少见的间叶源性肿瘤,绝大多数病例呈良性的生物学行为和临床经过,准确的病理诊断需要密切结合临床表现、形态学特点及免疫组化表达特征。

Objective To analyze the clinicopathological characteristics of glomus tumor originating from the stomach,and to compare other tumors with similar histological morphology from the stomach,so as to further improve the understanding of gastric glomus tumor.immunohistochemical characteristics of 22 cases of gastric glomus tumor collected from our department were observed and analyzed.Results Twenty-two primary hemangiomas were collected from the stomach,including 12 males and 10 females.The oldest was 66 years old and the youngest was 25 years old,with an average age of 50.18 years.The tumor was located in the stomach body in 6 cases,in the pylorus in 14 cases and 2 cases were located at the junction of the pylorus and body.The diameter of the tumors in this group was 8.0 cm in the largest,0.9 cm in the smallest,and the average diameter was 2.7 cm.In terms of pathological morphology,the tumor cells in this group consisted of small round and short spindle cells.Mainly(20/22),the morphology of some tumor cells was spindle-shaped.There were no clear tumor necrosis in 22 tumor nodules in this group.The average mitotic figure was 2/10 HPF;3 cases showed increased cell density,tumors were closely related to nerves and blood vessels,and had malignant potential characteristics.In immunohistochemistry,tumor cells in this group expressed SMA(22/22),and most tumor cells expressed the neuroendocrine marker Syn(15/18),a few cases expressed CD34(3/22),the average Ki-67 index of tumor cells in this group was 5%,and tumor cells in all cases in this group did not express CD56,CK,S-100,CD117,DOG-1.Conclusion Gastric glomus tumor is a rare mesenchymal tumor.The vast majority of cases show benign biological behavior and clinical experience.Accurate pathological diagnosis requires close combination of clinical manifestations,morphological characteristics and immunohistochemical expression characteristics.