Saito H, Akahoshi K, Oya M, Kubokawa M, Akiho H, Sumida Y, Fujimaru T, Higuchi N, Matsumoto M
Department of Gastroenterology, Aso Iizuka Hospital, Iizuka, Japan.
Acta Gastroenterol Belg. 2005 Apr-Jun;68(2):272-5.
A 60-year-old Japanese man was referred for treatment of a polypoid oesophageal tumour. Radiographic examination of the upper gastrointestinal tract disclosed a nodule with central depression in the lower esophagus. By endoscopy the nodule was yellowish and appeared submucosal. Endoscopic ultrasonography demonstrated a hypoechoic solid tumour limited in submucosa without lymph node involvement. Endoscopic resection using band ligation was performed under guidance by endoscopic ultrasonography. By histologic examination the tumour consisted of large cells arranged in nests. These cells had abundant granular cytoplasm and small round nuclei. They expressed S-100 protein and were CD68, and periodic acid-Schiff positive. No expression of alpha-smooth muscle actin was noted. The tumour was limited in submucosa. Findings were consistent with complete endoscopic resection. This report may be the first concerning an oesophageal granular cell tumour successfully treated with EUS-guided endoscopic resection using band ligation.
一名60岁的日本男性因息肉样食管肿瘤前来接受治疗。上消化道造影检查发现食管下段有一个中央凹陷的结节。内镜检查显示该结节呈淡黄色,似乎位于黏膜下层。内镜超声检查显示一个低回声实性肿瘤局限于黏膜下层,无淋巴结受累。在内镜超声引导下使用套扎术进行了内镜切除。组织学检查显示肿瘤由巢状排列的大细胞组成。这些细胞具有丰富的颗粒状细胞质和小圆形细胞核。它们表达S-100蛋白,CD68和过碘酸希夫染色呈阳性。未发现α-平滑肌肌动蛋白的表达。肿瘤局限于黏膜下层。结果与内镜完全切除一致。本报告可能是首例关于使用套扎术在内镜超声引导下成功治疗食管颗粒细胞瘤的报道。