Wada Yoshiki, Kadokura M, Kamio Y, Kitami A, Nakajima H, Inoue H, Shiokawa A
Department of Respiratory Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
Kyobu Geka. 2004 Dec;57(13):1250-3.
In September 2002, a 24-year-old woman complaining dysphagia with an abnormal shadow in a chest X-ray was admitted to our hospital. Endoscopic ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) showed a hypo-echoic, low-density mass surrounding the middle esophagus. Bronchofiberscopy and gastrofiberscopy showed compression from the outside of bronchus and esophagus. No ulcer formation was found. Transbronchial aspiration biopsy and esophageal biopsy showed no malignancy. After 14 cm thoractomy, extirpation of the tumor was performed. The solid tumor was 10.5 x 3.0 x 2.5 cm in dimension, and the cut surface of the tumor was light yellow. Immunohistochemically, the tumor cells were positive for c-kit, SMA, CD34, and S-100. Histopathologically, the tumor was diagnosed as gastrointestinal stromal tumor (GIST), combined smooth muscle-neural type. A postoperative upper gastrointestinal tract barium study showed no stenosis. She is doing well without evidence of tumor recurrence at 12 months postoperatively. Although GIST is the most common mensenchymal tumor of the human gastrointestinal tract, this case is reported because the GIST arising from the middle esophagus is very rare.
2002年9月,一名24岁女性因吞咽困难且胸部X光检查发现异常阴影而入住我院。内镜超声、计算机断层扫描(CT)和磁共振成像(MRI)显示中食管周围有低回声、低密度肿块。纤维支气管镜和纤维胃镜检查显示支气管和食管外部受压。未发现溃疡形成。经支气管针吸活检和食管活检未发现恶性肿瘤。在进行14厘米开胸手术后,切除了肿瘤。实体瘤尺寸为10.5×3.0×2.5厘米,肿瘤切面为淡黄色。免疫组织化学检查显示,肿瘤细胞c-kit、平滑肌肌动蛋白(SMA)、CD34和S-100呈阳性。组织病理学诊断为胃肠道间质瘤(GIST),合并平滑肌-神经型。术后上消化道钡餐检查未显示狭窄。术后12个月,她情况良好,无肿瘤复发迹象。尽管GIST是人类胃肠道最常见的间叶组织肿瘤,但由于起源于中食管的GIST非常罕见,故报道此病例。