Rodriguez Erika, Tellschow Steven, Steinberg David M, Montgomery Elizabeth
Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, Maryland.
Diagn Cytopathol. 2014 Feb;42(2):177-80. doi: 10.1002/dc.22913. Epub 2012 Aug 31.
Spindle cell lesions of the stomach are rare. They usually affect the submucosa or muscularis propria and therefore can be sampled by endoscopic fine needle aspiration. The most common tumor in this category is gastrointestinal stromal tumor (GIST), followed by leiomyoma and gastric schwannoma. Gastric schwannoma is a benign tumor of neuroectodermal origin that has overlapping morphologic/cytologic features with GIST and leiomyoma. Gastric schwannomas differ from peripheral schwannomas by lacking a capsule, Verocay bodies, Antoni B areas, and thick-walled vessels. They are characterized morphologically by poorly defined borders, cuffs of lymphoid tissue and a haphazard spindle cell proliferation. We present here the cytologic and histopathologic features of a gastric schwannoma. The tumor was composed of spindle cells with delicate eosinophilic cytoplasm and wavy nuclei, with an associated conspicuous lymphoid backdrop. The latter feature raised the possibility of a lymphoid lesion, a problem cytopathologists should be aware of.
胃的梭形细胞病变罕见。它们通常累及黏膜下层或固有肌层,因此可通过内镜细针穿刺取样。此类中最常见的肿瘤是胃肠道间质瘤(GIST),其次是平滑肌瘤和胃神经鞘瘤。胃神经鞘瘤是一种神经外胚层起源的良性肿瘤,在形态学/细胞学特征上与GIST和平滑肌瘤有重叠。胃神经鞘瘤与周围神经鞘瘤不同,缺乏包膜、Verocay小体、Antoni B区和厚壁血管。它们在形态上的特征是边界不清、淋巴组织套袖样改变和梭形细胞随意性增生。我们在此展示一例胃神经鞘瘤的细胞学和组织病理学特征。肿瘤由具有纤细嗜酸性细胞质和波浪状核的梭形细胞组成,伴有明显的淋巴背景。后一特征增加了淋巴病变的可能性,这是细胞病理学家应注意的问题。