Chiba W, Konishi T, Sawai S, Hatakenaka R, Matsubara Y, Ikeda S
Respiratory Disease Center, Kyoto Katsura Hospital, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1993 Jan;41(1):140-4.
A case of leiomyosarcoma of the esophagus was reported. The tumor was located in the lower esophagus. The esophagus was very stenotic, but the mucosa was clear. We thought the tumor had not invaded the mucosa. Enucleation was performed on the tumor. The tumor was encapsulated, so at the time of operation, the microscopic diagnosis was leiomyoma. However, after the operation, the diagnosis was changed to the leiomyosarcoma, because there are many spindle-shaped atypical cells, and many mitoses. We also analyzed the DNA content of the tumor. The DNA index of this tumor was 0.9 and 1.48, therefore, this tumor was DNA aneuploidy. The result of DNA content analysis showed that the tumor is malignant. DNA content analysis is helpful for diagnosis of this kind of sarcoma, because microscopic examination can not readily distinguish benign leiomyoma from malignant leiomyosarcoma. This patient was still alive one year after the operation. Thus, we thought that enucleation of the tumor is a good operational procedure to the leiomyosarcoma of the esophagus, if the tumor is polypoid type and encapsulated.
报告了一例食管平滑肌肉瘤病例。肿瘤位于食管下段。食管严重狭窄，但黏膜清晰。我们认为肿瘤未侵犯黏膜。对肿瘤进行了摘除术。肿瘤有包膜，因此手术时的显微镜诊断为平滑肌瘤。然而，术后诊断改为平滑肌肉瘤，因为有许多梭形非典型细胞和许多有丝分裂象。我们还分析了肿瘤的DNA含量。该肿瘤的DNA指数为0.9和1.48，因此，该肿瘤为DNA非整倍体。DNA含量分析结果表明该肿瘤为恶性。DNA含量分析有助于此类肉瘤的诊断，因为显微镜检查难以轻易区分良性平滑肌瘤和恶性平滑肌肉瘤。该患者术后一年仍存活。因此，我们认为，如果肿瘤为息肉样且有包膜，对食管平滑肌肉瘤进行肿瘤摘除术是一种良好的手术方法。
