Tashiro Yoshihiko, Matsumoto Fumio, Iwama Keiko, Shimazu Ai, Matsumori Sei, Nohara Shigeo, Miura Hiroyoshi, Takei Masahiko, Namekata Koji, Takase Masaru, Okada Motoi, Tsumura Hidenori
Department of Surgery, Koshigaya Municipal Hospital, Koshigaya, Japan.
Department of Pathology, Koshigaya Municipal Hospital, Koshigaya, Japan.
Case Rep Gastroenterol. 2015 Jan 16;9(1):15-9. doi: 10.1159/000373882. eCollection 2015 Jan-Apr.
Schwannomas of the colon are rare and difficult to diagnose preoperatively. We report a case of schwannoma of the ascending colon that was resected laparoscopically. A 64-year-old woman was referred to our hospital by her local clinic for further evaluation and management of a submucosal tumor of the ascending colon. A definitive preoperative diagnosis could not be reached despite examinations. Gastrointestinal stromal tumor, leiomyoma and lymphoma were the differential diagnoses. We performed a laparoscopic right hemicolectomy with D2 lymph node dissection. Histological findings with hematoxylin-eosin staining revealed spindle-like tumor cells, and immunohistochemical analysis showed that the tumor was positive for S-100 but negative for c-kit, CD34, smooth muscle actin and desmin, with a Ki-67 index of <5%. Thus, the diagnosis in this case was benign schwannoma of the ascending colon.
结肠神经鞘瘤罕见，术前难以诊断。我们报告一例经腹腔镜切除的升结肠神经鞘瘤病例。一名64岁女性因升结肠黏膜下肿瘤被当地诊所转诊至我院进一步评估和治疗。尽管进行了各项检查，但仍无法做出明确的术前诊断。鉴别诊断包括胃肠道间质瘤、平滑肌瘤和淋巴瘤。我们实施了腹腔镜右半结肠切除术并进行D2淋巴结清扫。苏木精-伊红染色的组织学检查发现梭形肿瘤细胞，免疫组化分析显示肿瘤S-100阳性，但c-kit、CD34、平滑肌肌动蛋白和结蛋白阴性，Ki-67指数<5%。因此，本例诊断为升结肠良性神经鞘瘤。
