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一例累及胃和脾脏的巨大炎性肌纤维母细胞瘤:病例报告及文献复习

A large inflammatory myofibroblastic tumor involving both stomach and spleen: A case report and review of the literature.

作者信息

Chen Wen-Chao, Jiang Zhen-Yu, Zhou Fan, Wu Zheng-Rong, Jiang Gui-Xing, Zhang Bu-Yi, Cao Li-Ping

机构信息

Department of General Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China.

Department of General Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China ; Department of General Surgery, Qing Chun Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China.

出版信息

Oncol Lett. 2015 Feb;9(2):811-815. doi: 10.3892/ol.2014.2761. Epub 2014 Dec 3.

Abstract

Inflammatory myofibroblastic tumor (IMT) is a rare, benign neoplasm that most commonly occurs in pediatric patients; it has been described as a pseudosarcomatous proliferation of spindled myofibroblasts mixed with lymphoplasmacytic cells. IMT has been reported in a number of locations throughout the body; however, cases occurring in the gastrointestinal tract are rare and to date, no case involving both the stomach and spleen has been reported. The current study presents a case of an extremely large IMT invading both the stomach and spleen in a 50-year-old female, presenting with a three-month history of left-sided abdominal distension without abdominal pain, fever or vomiting. As the tumor had invaded the stomach and spleen, it was completely excised and concomitantly, the entire stomach and spleen were removed. Histological examination of the biopsy revealed fascicles of spindle cells in a mixed inflammatory background, with inflammatory cells that were immunopositive for vimentin, smooth muscle actin, and negative for anaplastic lymphoma kinase and CD30, confirming the diagnosis of IMT. Four months following local excision of the mass, accompanied by a total gastrectomy and splenectomy, no abdominal distension, abdominal pain, fever or vomiting were observed and no IMT recurrence was identified.

摘要

炎性肌纤维母细胞瘤(IMT)是一种罕见的良性肿瘤,最常见于儿科患者;它被描述为梭形肌成纤维细胞与淋巴浆细胞混合的假肉瘤样增殖。IMT已在全身多个部位被报道;然而,发生在胃肠道的病例很少,迄今为止,尚未有涉及胃和脾的病例报道。本研究报告了一例50岁女性的巨大IMT,侵犯胃和脾,患者有三个月的左侧腹胀病史,无腹痛、发热或呕吐。由于肿瘤侵犯了胃和脾,故将其完整切除,同时切除了整个胃和脾。活检组织学检查显示在混合性炎症背景中有梭形细胞束,炎症细胞波形蛋白、平滑肌肌动蛋白免疫阳性,间变性淋巴瘤激酶和CD30免疫阴性,确诊为IMT。在肿物局部切除并进行全胃切除术和脾切除术后四个月,未观察到腹胀、腹痛、发热或呕吐,也未发现IMT复发。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a4a/4301536/51d3f3d5ed1b/OL-09-02-0811-g00.jpg

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