Ogasawara Naotaka, Izawa Shinya, Mizuno Mari, Tanabe Atsushi, Ozeki Tomonori, Noda Hisatsugu, Takahashi Emiko, Sasaki Makoto, Yokoi Toyoharu, Kasugai Kunio
Naotaka Ogasawara, Shinya Izawa, Mari Mizuno, Atsushi Tanabe, Tomonori Ozeki, Hisatsugu Noda, Makoto Sasaki, Kunio Kasugai, Department of Gastroenterology, Aichi Medical University School of Medicine, Aichi 480-1195, Japan.
World J Gastrointest Endosc. 2013 Sep 16;5(9):457-60. doi: 10.4253/wjge.v5.i9.457.
The World Health Organization describes calcifying fibrous tumors (CFTs) as rare, benign lesions characterized by hypocellular, densely hyalinized collagenization with lymphoplasmacytic infiltration. These tumors rarely involve the gastrointestinal (GI) tract. A routine endoscopic upper gastrointestinal screen detected a 10-mm submucosal tumor (SMT) in the lesser curvature of the lower corpus of the stomach of an apparently healthy, 37-year-old woman with no history of Helicobacter pylori infection. Endoscopic ultrasonography (EUS) localized the internally isoechoic, homogeneous SMT mainly within the submucosa. Malignancy was ruled out using endoscopic submucosal dissection (ESD). A pathological examination confirmed complete resection of the SMT, and defined a hypocellular, spindle-cell tumor with a densely hyalinized, collagenous matrix, scattered lymphoplasmacytic aggregates as well as a few psammomatous, dystrophic calcified foci. The mass was immunohistochemically positive for vimentin and negative for CD117 (c-kit protein), CD34, desmin, smooth muscle actin (SMA) and S100. Therefore, the histological findings were characteristic of a CFT. To date, CFT resection by ESD has not been described. This is the first case report of a gastric calcifying fibrous tumor being completely resected by ESD after endoscopic ultrasonography.
世界卫生组织将钙化性纤维瘤（CFTs）描述为罕见的良性病变，其特征为细胞稀少、胶原化致密且玻璃样变，并伴有淋巴浆细胞浸润。这些肿瘤很少累及胃肠道（GI）。在对一名37岁、表面健康且无幽门螺杆菌感染史的女性进行常规上消化道内镜筛查时，在胃体下部小弯处发现了一个10毫米的黏膜下肿瘤（SMT）。内镜超声检查（EUS）显示内部等回声、均匀的SMT主要位于黏膜下层。通过内镜黏膜下剥离术（ESD）排除了恶性肿瘤的可能。病理检查证实SMT已完全切除，病理显示为一个细胞稀少的梭形细胞瘤，具有致密的玻璃样变胶原基质、散在的淋巴浆细胞聚集以及一些砂粒体样、营养不良性钙化灶。该肿物免疫组化结果显示波形蛋白阳性，而CD117（c-kit蛋白）、CD34、结蛋白、平滑肌肌动蛋白（SMA）和S100均为阴性。因此，组织学表现符合CFT的特征。迄今为止，尚未有关于通过ESD切除CFT的报道。这是首例关于经内镜超声检查后通过ESD完整切除胃钙化性纤维瘤的病例报告。
