消化道神经鞘瘤临床病理分析

Clinicopathologic analysis of gastrointestinal schwannoma

目的探讨消化道神经鞘瘤的临床病理特点,为该病的诊断与鉴别诊断提供参考。方法回顾性分析陆军军医大学第二附属医院病理科诊断的32例消化道神经鞘瘤患者的临床资料、病理形态、免疫组化结果以及随访情况。结果 32例患者中女22例,男10例;其中28例位于胃,3例位于食管,1例位于乙状结肠。肿瘤直径0. 3～7 cm。镜下肿瘤细胞呈长梭形,排列呈编织状,周围可见淋巴细胞反应带。免疫组化示肿瘤细胞S-100均弥漫强阳性,灶性表达CD34或SMA,不表达CD117、DOG-1、Desmin。结论消化道神经鞘瘤与经典型神经鞘瘤可能为不同的肿瘤实体,术前易误诊为胃肠道间质瘤,S-100是病理诊断标记,肿瘤完全切除预后好。

Objective To investigate the clinicopathological features,dignosis,and differential diagnosis of gastrointestinal schwannoma.Methods A total of 32 patients of gastrointestinal schwannomas were retrospectively reviewed in terms of clinical data,pathological features,immunohistochemical results and follow-up information. Results The tumor were located in the stomach in 28 cases,esophagus in 3 cases,and sigmoid colon in 1 case. The size of the tumors ranged from 0. 3 cm to 7 cm in diameter. The tumors were composed spindle shaped cells with the lymphocytic cuffing at the peripheral part. Immunohistochemistry results showed that the tumor cells were strong positive for S-100.Conclusion Gastrointestinal schwannoma and classical schwannoma may be different types of tumors. It should be differentiated from gastrointestinal stromal tumor in the preoperative misdiagnosis. S-100 is the diagnostic marker,and the prognosis is well with complete tumor resection.