Yang Lian-He, Wang Jin-Ou, Ma Shuang, Zhu Zhi, Sun Jia-Xing, Ding Si-Lu, Li Guang, Xu Hong-Tao, Wang Liang, Dai Sun-Dong, Liu Yang, Miao Yuan, Jiang Gui-Yang, Fan Chui-Feng, Wang En-Hua
Department of Pathology, First Affiliated Hospital and College of Basic Medicine Sciences, China Medical University China.
Department of Pathology, Shengjing Hospital of China Medical University China.
Int J Clin Exp Pathol. 2015 Jan 1;8(1):1041-5. eCollection 2015.
We presented a case of 80-year-old male with long term stomachache, marasmus and anaemia. Endoscopic evaluation suggested the malignant ulcerative tumor on the Gastric antrum, and biopsy confirmed the diagnosis of gastric adenocarcinoma. Surprisingly, in resected specimen the pathologist found a nodule just below the ulcer with clear boundary and gray-yellow section. Histologically, the whole lesion was composed with adenocarcinoma area and spindle tumor cells area. In the spindle tumor cells area, the cells with round or oval nuclei, eosinophilic cytoplasm, and these cells showed bundle or fence-like arrangement. Immunohistochemistry study presented positive expression of vimentin, S-100 and GFAP, negative expression of SMA, desmin, CD34, CD117 and Dog-1, which suggested the diagnosis of co-occurrence of gastric adenocarcinoma and schwannoma. To our knowledge, it is an extremely rare case that only two cases have been reported.
我们报告了一例80岁男性，有长期腹痛、消瘦和贫血症状。内镜评估提示胃窦部有恶性溃疡性肿瘤，活检确诊为胃腺癌。令人惊讶的是，在切除标本中，病理学家在溃疡下方发现一个边界清晰、切面呈灰黄色的结节。组织学上，整个病变由腺癌区域和梭形肿瘤细胞区域组成。在梭形肿瘤细胞区域，细胞呈圆形或椭圆形核，嗜酸性细胞质，且这些细胞呈束状或栅栏状排列。免疫组织化学研究显示波形蛋白、S-100和胶质纤维酸性蛋白呈阳性表达，平滑肌肌动蛋白、结蛋白、CD34、CD117和Dog-1呈阴性表达，提示诊断为胃腺癌与神经鞘瘤同时存在。据我们所知，这是极为罕见的病例，仅报告过两例。
