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原发性阴道壁胃肠道外间质瘤:一种罕见侵袭性软组织肿瘤的显著临床病理特征

Primary extragastrointestinal stromal tumor arising in the vaginal wall: Significant clinicopathological characteristics of a rare aggressive soft tissue neoplasm.

作者信息

Liu Qiu-Yu, Kan Yun-Zhen, Zhang Meng-Yang, Sun Ting-Yi, Kong Ling-Fei

机构信息

Qiu-Yu Liu, Yun-Zhen Kan, Meng-Yang Zhang, Ting-Yi Sun, Ling-Fei Kong, Department of Pathology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou 450003, Henan Province, China.

出版信息

World J Clin Cases. 2016 Apr 16;4(4):118-23. doi: 10.12998/wjcc.v4.i4.118.

Abstract

Gastrointestinal (GI) stromal tumor is the most common mesenchymal neoplasm of the GI tract but also occurs with a lower frequency in extragastrointestinal regions and is called extragastrointestinal stromal tumor (EGIST). We report an unusual case of EGIST presenting as a vaginal mass. A 41-year-old woman presented with a gradually enlarging vaginal mass for the last 2 years. Physical examination revealed an elliptical, non-tender mass about 7.5 cm × 7 cm in size in the posterior vaginal wall and was resected completely. Under histological examination, the tumor showed a spindle cell type with coagulation necrosis, hemorrhage and high mitotic count. Immunohistochemical analysis revealed tumor cells were positive for DOG1, CD117, CD34 and p53 protein. Ki-67 labeling was 8%. Genetic analysis showed a deletion of exon 11 of the c-kit gene at codons 557-558. EGISTs should be kept in mind in the differential diagnosis in patients presenting with solid mass of the vaginal wall.

摘要

胃肠道间质瘤是胃肠道最常见的间叶性肿瘤,但在胃肠道外区域也有较低频率的发生,称为胃肠道外间质瘤(EGIST)。我们报告一例罕见的以阴道肿物为表现的EGIST病例。一名41岁女性在过去2年中出现逐渐增大的阴道肿物。体格检查发现阴道后壁有一个椭圆形、无压痛的肿物,大小约7.5 cm×7 cm,并将其完整切除。组织学检查显示肿瘤为梭形细胞型,伴有凝固性坏死、出血和高有丝分裂计数。免疫组化分析显示肿瘤细胞DOG1、CD117、CD34和p53蛋白呈阳性。Ki-67标记率为8%。基因分析显示c-kit基因第11外显子在密码子557-558处缺失。对于出现阴道壁实性肿物的患者,鉴别诊断时应考虑到EGIST。

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