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经内镜超声引导下细针穿刺术前诊断的胃血管球瘤:一例报告

Gastric glomus tumor with a preoperative diagnosis by endoscopic ultrasonography-guided fine needle aspiration: a case report.

作者信息

Hasuda Hirofumi, Hu Qingjiang, Miyashita Yu, Zaitsu Yoko, Tsuda Yasuo, Hisamatsu Yuichi, Nakashima Yuichiro, Ando Koji, Kimura Yasue, Yamada Yuichi, Oki Eiji, Oda Yoshinao, Mori Masaki

机构信息

Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582 Japan.

Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

出版信息

Int Cancer Conf J. 2020 Sep 15;10(1):35-40. doi: 10.1007/s13691-020-00444-0. eCollection 2021 Jan.

Abstract

A gastric glomus tumor (GGT) is a rare gastric submucosal tumor that can become malignant. A preoperative diagnosis would allow for a more informed decision regarding the treatment strategy. We present the case of an asymptomatic man with a GGT that was diagnosed during a preoperative examination. Upper gastrointestinal endoscopy was performed in a 64-year-old man and revealed a submucosal tumor at the lesser curvature of the antrum of the stomach. Endoscopic ultrasonography showed a 12-mm-sized hypoechoic tumor in the second and third layers of the stomach wall. A histologic diagnosis of GGT was made using endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA). Abdominal contrast-enhanced computed tomography was performed, but the identification of the tumor was difficult owing to poor enhancement. The gradual growth of the tumor made it necessary to perform an operation. Laparoscopy and endoscopy cooperative surgery was performed without any complications. The tumor cells were immunohistochemically positive for alpha-smooth muscle actin, h-caldesmon, and collagen type IV but were negative for desmin, discovered on GIST-1, S-100 protein, cluster of differentiation 34, epithelial membrane antigen, and cytokeratin AE1/AE3. The final diagnosis was identical to the preoperative diagnosis made using EUS-FNA. EUS-FNA is a useful method for the preoperative diagnosis of small submucosal tumors, including GGTs.

摘要

胃血管球瘤(GGT)是一种罕见的可发生恶变的胃黏膜下肿瘤。术前诊断有助于就治疗策略做出更明智的决策。我们报告一例在术前检查时诊断出的无症状男性GGT病例。对一名64岁男性进行了上消化道内镜检查,发现胃窦小弯处有一个黏膜下肿瘤。内镜超声显示胃壁第二和第三层有一个12毫米大小的低回声肿瘤。通过内镜超声引导下细针穿刺抽吸(EUS-FNA)做出了GGT的组织学诊断。进行了腹部增强计算机断层扫描,但由于强化不佳难以识别肿瘤。肿瘤逐渐生长使得有必要进行手术。实施了腹腔镜和内镜联合手术,未出现任何并发症。肿瘤细胞免疫组化显示α-平滑肌肌动蛋白、h-钙调蛋白和IV型胶原呈阳性,但结蛋白、GIST-1、S-100蛋白、分化簇34、上皮膜抗原和细胞角蛋白AE1/AE3呈阴性。最终诊断与使用EUS-FNA做出的术前诊断一致。EUS-FNA是术前诊断包括GGT在内的小黏膜下肿瘤的一种有用方法。

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