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
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.