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结肠硬化性髓外造血肿瘤:一例报告及文献复习

Sclerosing extramedullary hematopoietic tumor of the colon: A case report and literature review.

作者信息

Zuo Zhibo, Zhang Qi, Wu Wanxin, Li Xin, Zhang Lin, Wang Jingyu, Guo Zhiqin, Hu Shaoqing, Liu Hongyan

机构信息

Department of Pathology, First Hospital of Jiaxing, Jiaxing, Zhejiang 314000, P.R. China.

Graduate School of Nursing, Huzhou University, Huzhou, Zhejiang 313000, P.R. China.

出版信息

Exp Ther Med. 2023 Feb 10;25(3):132. doi: 10.3892/etm.2023.11831. eCollection 2023 Mar.

Abstract

Sclerosing extramedullary hematopoietic tumor (SEMHT) is a rare tumor that can occur in association with some chronic myeloproliferative neoplasms, particularly myelofibrosis. The morphology of SEMHT can mimic that of a wide variety of other lesions, both macroscopically and microscopically. SEMHT originating from the colon is extremely rare. The present study reports a case of SEMHT in the colon with involvement of the peri-intestinal lymph nodes. On the basis of the clinical symptoms and endoscopic results, a malignant tumor of colon was suspected. Pathological examination revealed the deposition of collagen and hematopoietic components in the fibrous mucus background. Immunohistochemical staining for CD61 confirmed the presence of atypical megakaryocytes, while immunohistochemical staining for myeloperoxidase and glycophorin A highlighted the existence of granulocyte and erythrocyte precursors, respectively. These findings combined with a clinical history of myelofibrosis led to the final diagnosis of SEMHT. The presence of atypical megakaryocytes with immature hematopoietic cell morphology and a good understanding of the clinical history of the patient are essential to prevent misdiagnosis. The present case emphasizes the necessity of reviewing previous hematological history and considering clinical findings together with the associated pathological results.

摘要

硬化性髓外造血肿瘤(SEMHT)是一种罕见肿瘤,可与某些慢性骨髓增殖性肿瘤相关发生,尤其是骨髓纤维化。SEMHT的形态在宏观和微观上都可模仿多种其他病变。起源于结肠的SEMHT极为罕见。本研究报告了1例累及肠周淋巴结的结肠SEMHT病例。根据临床症状和内镜检查结果,怀疑为结肠恶性肿瘤。病理检查显示在纤维黏液背景中有胶原和造血成分沉积。CD61免疫组化染色证实存在非典型巨核细胞,而髓过氧化物酶和血型糖蛋白A免疫组化染色分别突出显示了粒细胞和红细胞前体的存在。这些发现结合骨髓纤维化的临床病史得出SEMHT的最终诊断。存在具有未成熟造血细胞形态的非典型巨核细胞以及对患者临床病史的充分了解对于防止误诊至关重要。本病例强调了回顾既往血液病史并将临床发现与相关病理结果相结合的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9baf/9947575/c37d50badb70/etm-25-03-11831-g00.jpg

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