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胃钙化性纤维性假瘤,一种罕见的胃间叶组织肿瘤

[Gastric calcifying fibrous pseudotumor, a rare mesenchymal tumor of the stomach].

作者信息

Chatelain D, Lauzanne P, Yzet T, Guernou M, Delcenserie R, Regimbeau J-M, Sevestre H

机构信息

Service d'anatomie pathologique, CHU d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 01, France.

出版信息

Gastroenterol Clin Biol. 2008 May;32(5 Pt 1):441-4. doi: 10.1016/j.gcb.2008.01.031. Epub 2008 Mar 17.

Abstract

We report a case of calcifying fibrous pseudotumor fortuitously discovered on abdominal CT-scan in a 50 year-old woman presenting with metrorragia. CT-scan showed a 2 cm hypodense nodular tumor of the gastric wall with granular calcifications. Upper endoscopy showed a nodular tumor along the lesser curvature of the gastric body, covered by normal gastric mucosa and biopsies were negative. A diagnosis of gastric stromal tumor was suspected and a partial gastrectomy was performed. On gross examination surgical specimen showed a firm, whitish nodular tumor measuring 2 cm in diameter. On microscopic examination the tumor was composed of whorls of dense hyalinized collagen bundles with a few fibroblasts. There were psammomatous calcifications and nodular aggregates of mononuclear inflammatory cells. Immunohistochemically, spindle cells stained for vimentin. They did not stain for smooth muscle actin, desmin, CD34, CD117, S100 protein, Ki-67 and ALK-1. Surgical resection of the tumor was complete. Patient has no evidence of disease with a follow-up of 12 months. Only seven cases of gastric calcifiying fibrous pseudotumors have been reported in the literature. These benign tumors are usually incidentally discovered. They have characteristic imaging and microscopic features and appear as a distinct clinicopathologic entity different from stromal tumors.

摘要

我们报告一例在腹部CT扫描时偶然发现的钙化性纤维性假瘤,患者为一名50岁出现子宫出血的女性。CT扫描显示胃壁有一个2厘米的低密度结节性肿瘤,伴有颗粒状钙化。上消化道内镜检查显示胃体小弯侧有一个结节性肿瘤,表面覆盖正常胃黏膜,活检结果为阴性。怀疑为胃间质瘤,遂行部分胃切除术。大体检查手术标本显示为一个质地坚硬、白色的结节性肿瘤,直径2厘米。显微镜检查显示肿瘤由致密的玻璃样变胶原束漩涡组成,伴有少量成纤维细胞。有砂粒体样钙化和单核炎性细胞的结节状聚集。免疫组化显示,梭形细胞波形蛋白染色阳性。它们对平滑肌肌动蛋白、结蛋白、CD34、CD117、S100蛋白、Ki-67和ALK-1均无染色。肿瘤手术切除完整。随访12个月,患者无疾病证据。文献中仅报道过7例胃钙化性纤维性假瘤。这些良性肿瘤通常是偶然发现的。它们具有特征性的影像学和显微镜特征,表现为一种与间质瘤不同的独特临床病理实体。

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