Zámecník M, Sosna B, Chlumská A
Sikl's Department of Pathology, Faculty Hospital, Charles University, Pilsen, Czech Republic.
Cesk Patol. 2005 Oct;41(4):150-6.
A case of gastrointestinal stromal tumor (GIST) with an unusual glandular component is reported. The tumor was found in the gastric fundus of a 93-year-old woman. Histologically, the lesion showed a biphasic adenosarcoma-like structure. Typical low-grade spindle cell patterns of GIST were intermingled with numerous and partly cystic glands. The glandular epithelium had pyloric/foveolar-like appearance, with foci of intestinal metaplasia and low-grade dysplasia. The stromal component was immunoreactive for CD117 (c-kit) and CD34, and negative for myoid and neuroid markers. The ultrastructural examination found nondescript and undifferentiated spindle cells. The gastric mucosa and submucosa near the tumor contained a small area with features of gastritis cystica profunda, with glands similar to those present inside the tumor. Therefore, a collision of GIST and gastritis cystica profunda is suggested in the histogenesis of the lesion.
报告了一例具有不寻常腺性成分的胃肠道间质瘤（GIST）。该肿瘤发现于一名93岁女性的胃底。组织学上，病变呈现双相腺肉瘤样结构。GIST典型的低级别梭形细胞模式与众多且部分呈囊性的腺体相互交织。腺上皮具有幽门/小凹样外观，伴有肠化生灶和低级别发育异常。间质成分对CD117（c-kit）和CD34呈免疫反应，对肌样和神经样标记物呈阴性。超微结构检查发现无特征且未分化的梭形细胞。肿瘤附近的胃黏膜和黏膜下层包含一小片具有深部囊性胃炎特征的区域，其腺体与肿瘤内的腺体相似。因此，在该病变的组织发生过程中提示存在GIST与深部囊性胃炎的碰撞。
