论著 Original Article

胃神经鞘瘤临床病理分析

Published at: 2014年第34卷第4期

曲渊 1 , 徐玮 1 , 史传兵 2
1 江苏省肿瘤医院病理科
2 南京医科大学第二附属医院
通讯作者 玮 徐 Email: weixu1974@126.com
DOI: 10.3978/j.issn.2095-6959.10.3978/j.issn.2095-6959.2014.04.019
基金:
南京医科大学科技发展基金重点项目 2012NJMU084

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。


Clinicopathologic study of 10 cases of gastric schwannoma

Abstract

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.


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引用

引用本文: 渊 曲, 玮 徐, 传兵 史. 胃神经鞘瘤临床病理分析[J]. 临床与病理杂志, 2014, 34(4): 415-419.
Cite this article as: QV Yuan, XU Wei, SHI Chuanbing . Clinicopathologic study of 10 cases of gastric schwannoma[J]. Journal of Clinical and Pathological Research, 2014, 34(4): 415-419.