Aparato Digestivo, Hospital Universitario San Agustín, ESPAÑA.
Aparato Digestivo, Hospital Universitario San Agustín.
Rev Esp Enferm Dig. 2022 Jun;114(6):367-368. doi: 10.17235/reed.2022.8601/2022.
We report the case of a 62-year-old woman with no history of interest who presented with dyspepsia of 2 years' standing. Gastroscopy revealed a subepithelial lesion at the greater antral curvature with irregular surface and preserved mucosal and vascular pattern, 15 mm in diameter. Because of clinical persistence a radial endoscopic ultrasonogram (EUS) was performed, which showed a well-delimited hypoechoic lesion with heterogeneous areas that was dependent on the muscularis mucosae layer. A biopsy was obtained using the "bite-on-bite" technique, which provided no pathological findings. With these findings an endoscopic submucosal dissection (ESD) procedure was performed with wide margins and no complications. Pathology found low-grade mesenchymal fusicellular proliferation dependent on the muscularis mucosae with immunohistochemistry positive for smooth-muscle vimentin and actin, consistent with plexiform fibromyxoma.
我们报告了一例 62 岁女性病例，该患者无相关病史，表现为持续性 2 年的消化不良。胃镜检查显示胃大弯处有一个位于黏膜下层的病变，表面不规则，保留有黏膜和血管模式，直径 15 毫米。由于临床持续存在，进行了径向内镜超声检查（EUS），显示界限清楚的低回声病变，伴有异质性区域，依赖于黏膜肌层。使用“咬-咬”技术进行了活检，但未发现病理结果。根据这些发现，进行了内镜黏膜下剥离（ESD）手术，边缘较宽，无并发症。病理检查发现，低级别间叶纤维母细胞增殖，依赖于黏膜肌层，免疫组织化学显示平滑肌波形蛋白和肌动蛋白阳性，符合丛状纤维黏液瘤。
