Onişor Danusia Maria, Boeriu Alina Mioara, Mocan Simona Liliana, Bartha Jenő Róbert, Coroş Marius Florin, Dobru Ecaterina Daniela
Department of Gastroenterology, University of Medicine and Pharmacy of Tîrgu Mureş, Romania;
Rom J Morphol Embryol. 2018;59(2):563-568.
Vanek's tumor or inflammatory fibroid polyp (IFP) is a rare submucosal, mesenchymal tumor of the digestive tract, of unknown etiology. We present an unusual case of a 62-year-old female patient, investigated for intermittent nausea, vomiting, abdominal pain and anemia. Narrow-band imaging (NBI) endoscopy showed a polypoid tumor with normal coverage mucosa prolapsing through the pylorus. The tumor was surgically removed. Histopathological (HP) examination revealed the presence of spindle cells with uniform nuclei exhibiting no mitotic activity. The inflammatory cells were predominantly represented by eosinophils. The vascular component was prominent suggesting a vascular lesion. We put emphasis on the presentation of this particular case because of its scarcity among the other types of gastric polyps, suspicion for features of malignancy, and the particularities of the clinical presentation, consisting of intermittent gastric outlet obstruction ("ball valve syndrome") accompanied by weight loss and anemia. The differential diagnosis of other benign or malignant gastric lesions was based on endoscopic, computed tomography and HP aspects.
瓦内克氏肿瘤或炎性纤维瘤息肉(IFP)是一种罕见的消化道黏膜下间叶组织肿瘤,病因不明。我们报告一例不寻常的病例,患者为一名62岁女性,因间歇性恶心、呕吐、腹痛和贫血接受检查。窄带成像(NBI)内镜检查显示一个黏膜覆盖正常的息肉样肿瘤经幽门脱垂。该肿瘤经手术切除。组织病理学(HP)检查显示存在核均匀的梭形细胞,未见有丝分裂活性。炎性细胞主要为嗜酸性粒细胞。血管成分突出,提示为血管病变。我们着重介绍这一特殊病例,是因为它在其他类型的胃息肉中较为罕见,怀疑有恶性特征,且临床表现具有特殊性,包括间歇性胃出口梗阻(“球阀综合征”)并伴有体重减轻和贫血。其他良性或恶性胃部病变的鉴别诊断基于内镜、计算机断层扫描和HP检查结果。