Department of Pathology, Laboratory Medicine Programme, University Health Network/University of Toronto, Toronto, Canada M5G 2C4.
Ann Diagn Pathol. 2010 Apr;14(2):125-8. doi: 10.1016/j.anndiagpath.2009.06.002. Epub 2009 Aug 6.
A 58-year-old man presented with epigastric pain that was refractory to analgesia. Before this, he was well and did not have manifestations of type 1 neurofibromatosis. Endoscopy revealed a 0.5-cm polypoid antral lesion that was snared and removed in total. Histological evaluation showed a submucosal myxoid spindle-cell proliferation. The tumor was arranged in whorls with distinct concentricity. Within the myxoid stroma, occasional eosinophils were present together with a delicate capillary network. There was no cytological atypia, areas of hypercellularity, or necrosis. The lesion was strongly positive for epithelial membrane antigen and also positive for CD34. All other markers including S-100, desmin, and CD117 were negative. The overall morphological and immunophenotypic features of this lesion are in keeping with a myxoid gastric perineurioma. This lesion needs to be separated from an inflammatory fibroid polyp and a gastrointestinal stromal tumor.
一位 58 岁男性因上腹疼痛就诊，且该疼痛对镇痛治疗无效。在此之前，他身体状况良好，没有 1 型神经纤维瘤病的表现。内镜检查显示 0.5cm 大小的息肉样胃窦病变，整块圈套切除。组织学评估显示黏膜下黏液样梭形细胞增生。肿瘤呈漩涡状排列，具有明显的同心性。黏液样基质中偶尔可见嗜酸性粒细胞和精细的毛细血管网。无细胞学异型性、细胞丰富区或坏死。该病变上皮膜抗原强阳性，CD34 阳性。所有其他标志物（包括 S-100、结蛋白和 CD117）均为阴性。该病变的整体形态学和免疫表型特征与黏液样胃神经鞘瘤一致。该病变需要与炎性纤维息肉和胃肠道间质瘤相鉴别。
