Tajima Shogo, Koda Kenji
Department of Pathology, Shizuoka Saiseikai General Hospital, Shizuoka, Japan
Department of Pathology, Fujieda Municipal General Hospital, Shizuoka, Japan.
Gastroenterol Rep (Oxf). 2018 May;6(2):144-148. doi: 10.1093/gastro/gow019. Epub 2016 Jun 10.
Morphologically, an inflammatory fibroid polyp (IFP) is usually centred in the submucosa. Extension of an IFP to the subserosa with destruction of the muscularis propria is exceedingly rare. Herein, we describe a 70-year-old woman who presented with right lower abdominal pain but was finally diagnosed with an IFP. Contrast-enhanced computed tomography revealed a target-like structure with a hypovascular mass at the leading edge, which was consistent with intussusception due to a tumour. Following surgery, the resected specimen displayed a mass measuring 4 × 3 × 3 cm that was protruding into the lumen. Microscopically, the mass was centred in the submucosa, extending up to the mucosal surface and down to the subserosa and serosa. The muscularis mucosae and muscularis propria were destroyed focally. A PDGFRA gene mutation in exon 2 (1837_1851 del) that was found in this case, as well as a highly infiltrative growth pattern, strongly supported the neoplastic nature of IFP.
从形态学上看，炎性纤维瘤息肉（IFP）通常位于黏膜下层中央。IFP延伸至浆膜下层并破坏固有肌层的情况极为罕见。在此，我们描述一名70岁女性，她因右下腹痛就诊，最终被诊断为IFP。增强计算机断层扫描显示一个靶样结构，前缘有一个低血运肿块，这与肿瘤导致的肠套叠相符。手术后，切除的标本显示一个大小为4×3×3 cm的肿块突入管腔。显微镜下，肿块位于黏膜下层中央，向上延伸至黏膜表面，向下延伸至浆膜下层和浆膜。黏膜肌层和固有肌层有局灶性破坏。该病例中发现的第2外显子（1837_1851缺失）的血小板衍生生长因子受体A（PDGFRA）基因突变以及高度浸润性生长模式，有力地支持了IFP的肿瘤性质。
