Nose Yohei, Takeno Atsushi, Masuzawa Toru, Toya Keisuke, Yukawa Yoshiro, Mori Ryota, Kawai Kenji, Sakamoto Takuya, Murakami Kohei, Naito Atsushi, Katsura Yoshiteru, Ohmura Yoshiaki, Kagawa Yoshinori, Takeda Yutaka, Murata Kohei
Dept. of Surgery, Kansai Rosai Hospital.
Gan To Kagaku Ryoho. 2018 Dec;45(13):1952-1954.
Schwannomas are rarely observed in the gastrointestinal tract. A 63-year-old man was referred to our hospital with gastric submucosal tumor with central ulceration by upper gastrointestinal endoscopy. Biopsy was performed, but pathological diagnosis was not obtained. A contrast-enhanced computed tomography scan of the abdomen revealed a round mass in the lower part of the stomach and regional lymphadenopathies. A distal gastrectomy with dissection of the regional lymph nodes (D2)was performed. The submucosal tumor measuring 67×49mm was resected. Histopathological examination revealed spindle-shaped cells arranged in palisades. The specimen was positive for S-100 protein, but negative for desmin, SMA, c-kit, and CD34. No tumor cells were found in the resected enlarged lymph nodes, indicating reactive lymphadenopathies. Based on these findings, the tumor was identified as a benign gastric schwannoma. Our patient shows no recurrence at 6 month follow-up.
胃肠道很少见神经鞘瘤。一名63岁男性因上消化道内镜检查发现胃黏膜下肿瘤伴中央溃疡而转诊至我院。进行了活检，但未获得病理诊断。腹部增强计算机断层扫描显示胃下部有一个圆形肿块及区域淋巴结肿大。行远端胃切除术并清扫区域淋巴结（D2）。切除了大小为67×49mm的黏膜下肿瘤。组织病理学检查显示梭形细胞呈栅栏状排列。标本S-100蛋白阳性，但结蛋白、平滑肌肌动蛋白、c-kit和CD34阴性。切除的肿大淋巴结中未发现肿瘤细胞，提示为反应性淋巴结肿大。基于这些发现，该肿瘤被确诊为良性胃神经鞘瘤。我们的患者在6个月的随访中未出现复发。
