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成人肠套叠中肿瘤和肿瘤样病变的临床病理表现。

The Clinico-histopathological Spectrum of Tumors and Tumor-Like Lesions in Adult Intussusception.

机构信息

Dept of Pathology and Lab Medicine, AIIMS, Bhubaneswar, PIN-751019, India.

Dept of General Surgery, AIIMS, Bhubaneswar, PIN-751019, India.

出版信息

J Gastrointest Cancer. 2022 Sep;53(3):511-519. doi: 10.1007/s12029-021-00647-5. Epub 2021 May 20.

Abstract

BACKGROUND

Intussusception is an uncommon cause of intestinal obstruction in adults. The etiology of this disease differs from the children. Thus, its management depends on the possible etiology and is different from pediatric cases.

AIMS

We aimed to study the clinico-histopathological spectrum of the tumors and tumor-like lesions in the intussusception in adults.

MATERIAL AND METHODS

A retrospective review of the adult (> 18 years) intussusception cases was performed. The clinical data and follow-up were obtained. The histopathology was reviewed along with the special stains and immunohistochemistry for ascertaining a histopathological diagnosis.

RESULTS

Fifteen cases of adult intussusception were identified from 107 resected specimens of adult intestinal obstruction. The mean age was 44.5 years with a male/female ratio of 1.1:1. A definitive pathology could be ascertained in 80% of the cases (n = 12/15). Eight cases had benign non-neoplastic etiology (53.3%) (33.3% tumor-like lesions) while seven cases (46.7%) had neoplastic etiology (20% benign neoplastic; 26.7% malignant neoplastic). All cases of colonic or enterocolic intussusceptions were associated with neoplasia whereas 90% of the enteric intussusceptions occurred due to benign non-neoplastic causes.  CONCLUSIONS: Non-neoplastic causes are predominant in the enteric intussusceptions while neoplastic causes are more commonly associated with colonic or enterocolic intussusceptions. The post-operative histopathological examination concludes on the adequacy of the index surgery or the provision of further management if required.

摘要

背景

肠套叠在成人中是一种罕见的肠梗阻原因。这种疾病的病因与儿童不同。因此,其治疗取决于可能的病因,与儿科病例不同。

目的

我们旨在研究成人肠套叠中肿瘤和肿瘤样病变的临床病理谱。

材料和方法

对 107 例成人肠梗阻切除标本中的成人肠套叠病例进行回顾性分析。获取临床数据和随访。对组织病理学进行复习,并进行特殊染色和免疫组织化学检查,以确定组织病理学诊断。

结果

从 107 例成人肠梗阻切除标本中确定了 15 例成人肠套叠病例。平均年龄为 44.5 岁,男女比例为 1.1:1。80%的病例(n=12/15)可以明确确定明确的病理学诊断。8 例为良性非肿瘤性病因(53.3%)(33.3%为肿瘤样病变),7 例为肿瘤性病因(46.7%)(20%为良性肿瘤;26.7%为恶性肿瘤)。所有结肠或肠套叠肠套叠均与肿瘤有关,而 90%的肠套叠是由良性非肿瘤性原因引起的。

结论

非肿瘤性病因在肠套叠中更为常见,而肿瘤性病因更常与结肠或肠套叠肠套叠有关。术后组织病理学检查可确定指数手术的充分性,或在需要时提供进一步的治疗。

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