Matsukuma S, Wada R, Hase K, Sakai Y, Ogata S, Kuwabara N
Department of Research and Laboratory, Japan Self Defense Forces Central Hospital, Tokyo.
Pathol Int. 1997 Jan;47(1):73-7. doi: 10.1111/j.1440-1827.1997.tb04438.x.
Gastric carcinosarcoma is an unusual tumor and its occurrence in the gastric stump is extremely rare. A report is presented here of a unique case of gastric stump carcinosarcoma with rhabdomyosarcomatous differentiation in a 74-year-old man. The patient had undergone partial gastrectomy with gastrojejunostomy (Billroth II method) 30 years previously. The tumor had both adenocarcinoma and sarcoma components, and an immunohistochemical study suggested a focal transition between these components. The main sarcomatous components showed fibrosarcomatous features with a scattered distribution of rounded tumor cells, whose rhabdomyosarcomatous differentiation was immunohistochemically determined. Ultrastructural examination supported the rhabdomyosarcomatous natures. Experience with the present tumor indicates that carcinosarcoma with rhabdomyosarcomatous differentiation can occur in the gastric stump and that this disease is capable of aggressive behavior.
胃肉瘤样癌是一种罕见的肿瘤，其发生于胃残端极为罕见。本文报告了一例74岁男性胃残端肉瘤样癌伴横纹肌肉瘤分化的独特病例。该患者30年前接受了胃部分切除术及胃空肠吻合术（毕Ⅱ式）。肿瘤具有腺癌和肉瘤成分，免疫组化研究提示这些成分之间存在局灶性转变。主要的肉瘤成分表现为纤维肉瘤特征，有散在分布的圆形肿瘤细胞，其横纹肌肉瘤分化通过免疫组化得以确定。超微结构检查支持横纹肌肉瘤的性质。该肿瘤的经验表明，伴横纹肌肉瘤分化的肉瘤样癌可发生于胃残端，且这种疾病具有侵袭性。
