Sakata Masahiro, Kaneyoshi Toshihiko, Fushimi Takashi, Watanabe Jiro
Department of Gastroenterology National Hospital Organization, Fukuyama Medical Center Fukuyama Japan.
Department of Laboratory and Pathology National Hospital Organization, Fukuyama Medical Center Fukuyama Japan.
JGH Open. 2021 Jan 5;5(3):408-409. doi: 10.1002/jgh3.12487. eCollection 2021 Mar.
Gastrointestinal stromal tumors (GISTs) are rare mesenchymal neoplasms of the gastrointestinal tract with an annual incidence of 1-2 per 10 000 people. Although most GISTs are solid, they may present with predominantly cystic components. A 69-year-old Japanese woman presented with a recently elevated gamma-glutamyl transpeptidase level. Computed tomography revealed multiple space-occupying lesions (SOLs) in the liver. These SOLs appear cystic on magnetic resonance imaging and abdominal ultrasound and are associated with thick walls at the margins. In addition, these thick walls showed high intensity on diffusion-weighted images. She was diagnosed with liver metastasis of GIST by diagnostic biopsies from the thick parts of the cystic liver lesion (thick walls at the margins). The primary lesion was thought to be located along the medial side of the descending part of the duodenum, but a duodenal biopsy was initially undiagnosed. Liver metastases due to GISTs are known to cause cystic changes after treatment, such as imatinib mesylate. However, to the best of our knowledge, only six cases where hepatic GIST with predominantly cystic changes (prior to any treatment) have been reported. It should be noted that GISTs appear cystic in all organs.
胃肠道间质瘤（GISTs）是胃肠道罕见的间叶性肿瘤，年发病率为每10000人中有1 - 2例。尽管大多数GISTs是实性的，但它们可能主要表现为囊性成分。一名69岁的日本女性出现γ-谷氨酰转肽酶水平近期升高。计算机断层扫描显示肝脏有多个占位性病变（SOLs）。这些SOLs在磁共振成像和腹部超声上呈囊性，边缘有厚壁。此外，这些厚壁在扩散加权图像上显示为高信号。通过对肝囊肿性病变的厚壁部分（边缘厚壁）进行诊断性活检，她被诊断为GIST肝转移。原发病灶被认为位于十二指肠降部内侧，但最初十二指肠活检未确诊。已知GISTs导致的肝转移在治疗后会引起囊性改变，如甲磺酸伊马替尼治疗后。然而，据我们所知，仅报道了6例主要为囊性改变（在任何治疗之前）的肝脏GISTs病例。应当注意的是，GISTs在所有器官中都可表现为囊性。
