Matsukuma S, Doi M, Suzuki M, Ikegawa K, Sato K, Kuwabara N
Department of Research and Laboratory, Japan Self Defense Forces Central Hospital, Tokyo, Japan.
Pathol Int. 1997 Nov;47(11):789-93. doi: 10.1111/j.1440-1827.1997.tb04459.x.
A unique case of duodenal stromal tumor in a 51-year-old man is reported. The tumor histologically showed spindle cell proliferation and numerous eosinophilic globules. Most globules were composed of tangled 45 nm thick fibrils, which were ultrastructurally identical to 'skeinoid fibers'. The presence of glycogen granules in the tumor cells and the immunoreactivity for alpha-smooth muscle actin suggested smooth muscle differentiation. Focal ultrastructural findings also supported the smooth muscle nature of this tumor. There were no immunohistochemical and ultrastructural features indicating neural differentiation. In previous studies, the presence of such 'skeinoid fibers' was suggested to be a histological marker for neural differentiation in gastrointestinal stromal tumor. However, the findings in the present case suggest that numerous 'skeinoid fibers' can be identified in duodenal stromal tumor with smooth muscle differentiation, although this condition may be rare.
报告了一例51岁男性十二指肠间质瘤的独特病例。肿瘤组织学显示梭形细胞增生和大量嗜酸性小球。大多数小球由缠结的45纳米厚的纤维组成，超微结构上与“扭曲纤维”相同。肿瘤细胞中糖原颗粒的存在以及对α-平滑肌肌动蛋白的免疫反应性提示平滑肌分化。局部超微结构发现也支持该肿瘤的平滑肌性质。没有免疫组织化学和超微结构特征表明神经分化。在先前的研究中，这种“扭曲纤维”的存在被认为是胃肠道间质瘤神经分化的组织学标志物。然而，本病例的发现表明，尽管这种情况可能罕见，但在具有平滑肌分化的十二指肠间质瘤中可以识别出大量“扭曲纤维”。
