胃锯齿状肿瘤：一种新的实体。
Serrated neoplasia of the stomach: a new entity.
作者信息
Rubio C A
机构信息
Gastrointestinal and Liver Pathology Research Laboratory, Karolinska Institute and Hospital, 171 76 Stockholm, Sweden.
出版信息
J Clin Pathol. 2001 Nov;54(11):849-53. doi: 10.1136/jcp.54.11.849.
AIM
Despite the fact that gastric carcinoma continues to be one of the most common cancers world wide, only dysplasia in flat mucosa and adenomas have been shown to evolve into invasive carcinoma. The aim of this paper is to report a novel histological phenotype of gastric adenoma with early invasive growth.
MATERIAL AND RESULTS
The patient presented with gastric complaints. A barium examination revealed an ulcerated tumour in the corpus, apparently infiltrating the gastric wall. The endoscopic examination showed a pediculated protruding tumour in the greater curvature. Punch biopsies were reported as invasive adenocarcinoma. Because of the poor condition of the patient, a partial gastrectomy was performed. The histological examination revealed elongated fronds with lateral crenated, saw tooth-like notches as a result of scalloped epithelial indentations. Areas with high grade dysplasia, with carcinoma in situ, and invasive carcinoma at the tip of the adenoma were demonstrated. The pedicle of the protruding neoplasia "emerged" from a non-protruding serrated adenoma.
CONCLUSIONS
The protruding serrated neoplasia had apparently evolved from a non-protruding serrated gastric adenoma. This appears to be the first case of gastric serrated neoplasia in the literature.
目的
尽管胃癌仍是全球最常见的癌症之一，但只有扁平黏膜发育异常和腺瘤会发展为浸润性癌。本文旨在报告一种具有早期浸润性生长的胃腺瘤新组织学表型。
材料与结果
患者有胃部不适症状。钡餐检查显示胃体部有一个溃疡型肿瘤，明显侵犯胃壁。内镜检查显示大弯侧有一个带蒂突出肿瘤。活检报告为浸润性腺癌。由于患者病情较差，进行了胃部分切除术。组织学检查显示有细长的叶状结构，因上皮呈扇形凹陷而在侧面有锯齿状、类似锯子齿状的切口。显示出高级别发育异常区域、原位癌以及腺瘤顶端的浸润性癌。突出肿瘤的蒂从一个非突出的锯齿状腺瘤“长出”。
结论
突出的锯齿状肿瘤显然是从一个非突出的锯齿状胃腺瘤发展而来。这似乎是文献中首例胃锯齿状肿瘤。
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