胃钙化性纤维性肿瘤九例并文献复习

Calcifying fibrous tumor of the stomach:report of nine cases and review of literature

目的探讨胃钙化性纤维性肿瘤(CFT)的临床病理特征和病理诊断方法。方法回顾性分析2015年8月至2020年5月河北医科大学第二医院收治的9例胃CFT患者的临床病理资料。采用免疫组织化学法检测胃CFT免疫表型特征,并复习相关文献。结果9例胃CFT患者中,男性1例,女性8例,中位年龄53岁(18~63岁)。7例发生在胃体,2例发生在胃底。大体检查示均为实性单发结节,切面灰白、灰红色,质地硬韧,肿瘤长径0.6~1.5 cm。镜下观察可见在大量胶原化的间质内稀疏分布梭形肿瘤细胞,散在淋巴细胞、浆细胞浸润。9例均可见沙砾体或钙化。9例肿瘤细胞均表达Vimentin,3例表达CD34,均不表达PDGFRA、SMA、SMMS-1、Desmin、ALK、DOG-1、CD117、S-100、β-catenin、CKpan及calponin,Ki-67阳性指数1%~3%。结论胃CFT好发于中老年人,胃体多见,体积较小;诊断主要依靠病理形态及免疫组织化学检查,需要与多种好发于胃的梭形细胞肿瘤相鉴别。

Objective To investigate the clinicopathological features and pathological diagnosis methods of calcifying fibrous tumor(CFT)of the stomach.Methods The clinicopathological data of 9 patients with gastric CFT in the Second Hospital of Hebei Medical University from August 2015 to May 2020 were retrospectively analyzed,immunohistochemistry was used to detect the immunophenotypic characteristics of gastric CFT,and the relevant literature was reviewed.Results Among 9 patients with gastric CFT,1 case was male and 8 cases were female,with a median age of 53 years old(18-63 years old).There were 7 cases occurred in the body of the stomach,while 2 cases in the fundus.All cases were single solid nodule with the cut surface gray-white or gray-red in colour and hard and tough in texture.Maximum diameter of tumor ranged from 0.6 cm to 1.5 cm.Observation under the microscope showed the spindle-shaped tumor cells were sparsely distributed in a large amount of collagenized stroma with scattered lymphocytes and plasma cells infiltration.Calcification or gravel formation was detected in all cases.The tumor cells in 9 cases expressed Vimentin,3 cases expressed CD34,none of them expressed PDGFRA,SMA,SMMS-1,Desmin,ALK,DOG-1,CD117,S-100,β-catenin,CKpan and calponin;Ki-67 positive index was 1%-3%.Conclusions Gastric CFT is more common in middle-aged and elderly people,which is characterized by gastric body with smaller volume.The diagnosis of gastric CFT mainly depends on pathological morphology and immunohistochemical examination.It needs to be differentiated from a variety of spindle cell tumors more commonly found in the stomach.