Department of Pathology, NYU Grossman School of Medicine, New York, New York, USA.
Department of Pathology, NYU Langone Health, New York, New York, USA.
Diagn Cytopathol. 2022 Mar;50(3):E100-E106. doi: 10.1002/dc.24914. Epub 2021 Dec 6.
Glomus tumors make up 1% of stromal tumors of the stomach. Radiologic diagnosis of glomus tumors can be challenging as they share imaging characteristics with other neuroendocrine tumors and gastrointestinal stromal tumors. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has been reported as a useful method for the evaluation of gastrointestinal lesions. We report two cases of gastric glomus tumors in which EUS-FNA diagnosis was challenging. Cytologically, neoplastic cells were round to oval, uniform, bland appearing epithelioid cells with delicate chromatin and inconspicuous to vague nucleoli. Both samples lacked worrisome features such as high nuclear grade, high mitotic rate, and necrosis. Neoplastic cells were negative for Cam5.2 and AE1/AE3 with focal expression of synaptophysin in one of the cases. A definitive diagnosis was not made based on FNA. Familiarity with glomus tumors in the GI system and procurement of adequate material for cell block allowing the use of immunohistochemistry may allow an accurate preoperative diagnosis.
胃肠道血管球瘤约占胃间质肿瘤的 1%。由于其与其他神经内分泌肿瘤和胃肠道间质肿瘤具有相似的影像学特征，因此胃肠道血管球瘤的放射学诊断具有一定挑战性。超声内镜引导下细针抽吸（EUS-FNA）已被报道为评估胃肠道病变的一种有用方法。我们报告了两例胃血管球瘤，EUS-FNA 诊断具有一定挑战性。细胞学上，肿瘤细胞呈圆形至椭圆形，大小一致，呈温和的上皮样细胞，染色质细腻，核仁不明显或模糊。两个样本均缺乏令人担忧的特征，如高核级、高有丝分裂率和坏死。肿瘤细胞 Cam5.2 和 AE1/AE3 阴性，其中一个病例突触素呈局灶性表达。基于 FNA 无法做出明确诊断。熟悉胃肠道中的血管球瘤，并获取足够的细胞块材料以进行免疫组织化学检查，可能有助于做出准确的术前诊断。
