Funahashi Hitoshi, Okada Yuji, Sawai Hirozumi, Wakasugi Takehiro, Akamo Yoshimi, Manabe Tadao
Gastroenterological Surgery, Nagoya City University Graduated School of Medical Sciences, Mizuho-ku, Nagoya, Japan.
Int Surg. 2008 Jan-Feb;93(1):45-9.
Gastrointestinal stromal tumors (GISTs) are characterized by remarkable variability in their differentiation potential, but most of these lesions do not display convincing smooth muscle or neuronal differentiation. Here we report the case of a 65-year-old woman who underwent a perfect resection of a large submucosal tumor that displayed extragastric growth. The specimen was revealed to be an elastic soft tumor, 18 x 25 x 11 cm in size. Histologically, the tumor consisted of spindle-shaped cells, with a mitotic rate of 12 per 10 high-power fields. Immunohistochemically, the tumor showed positive staining for CD34 and c-kit but negative staining for alpha-smooth muscle actin, Desmin, and s-100 protein. From these findings, the tumor was diagnosed as an uncommitted type of GIST with high-grade malignancy. This case needs careful and long-term follow-up to monitor for signs of local recurrence or distant metastasis.
胃肠道间质瘤（GISTs）的特点是其分化潜能具有显著变异性，但这些病变大多未表现出令人信服的平滑肌或神经分化。在此，我们报告一例65岁女性病例，该患者接受了一个向胃外生长的大的黏膜下肿瘤的完美切除。标本显示为一个弹性软肿瘤，大小为18×25×11厘米。组织学上，肿瘤由梭形细胞组成，每10个高倍视野有12个有丝分裂象。免疫组化方面，肿瘤CD34和c-kit染色阳性，但α-平滑肌肌动蛋白、结蛋白和s-100蛋白染色阴性。根据这些发现，该肿瘤被诊断为未分化型高级别恶性GIST。该病例需要仔细和长期随访以监测局部复发或远处转移迹象。
