Voltaggio Lysandra, Montgomery Elizabeth A
Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Mod Pathol. 2015 Jan;28 Suppl 1:S47-66. doi: 10.1038/modpathol.2014.126.
Interpretation of gastrointestinal tract mesenchymal lesions is simplified merely by knowing in which anatomic layer they are usually found. For example, Kaposi sarcoma is detected on mucosal biopsies, whereas inflammatory fibroid polyp is nearly always in the submucosa. Gastrointestinal stromal tumors (GISTs) are generally centered in the muscularis propria. Schwannomas are essentially always in the muscularis propria. Mesenteric lesions are usually found in the small bowel mesentery. Knowledge of the favored layer is even most important in interpreting colon biopsies, as many mesenschymal polyps are encountered in the colon. Although GISTs are among the most common mesenchymal lesions, we will concentrate our discussion on other mesenchymal lesions, some of which are in the differential diagnosis of GIST, and point out some diagnostic pitfalls, particularly in immunolabeling.
仅通过了解胃肠道间质性病变通常位于哪一层解剖结构，就能简化对它们的解读。例如，卡波西肉瘤在黏膜活检中被检测到，而炎性纤维性息肉几乎总是位于黏膜下层。胃肠道间质瘤（GIST）通常以固有肌层为中心。神经鞘瘤基本上也总是位于固有肌层。肠系膜病变通常见于小肠系膜。在解读结肠活检时，了解病变最常累及的层次尤为重要，因为结肠中会遇到许多间质性息肉。虽然GIST是最常见的间质性病变之一，但我们将把讨论集中在其他间质性病变上，其中一些病变在GIST的鉴别诊断中会涉及，并指出一些诊断陷阱，尤其是在免疫标记方面。
