Seki K, Hasegawa T, Konegawa R, Hizawa K, Sano T
Department of Pathology, Tokushima Municipal Hospital, Japan.
Jpn J Clin Oncol. 1998 Apr;28(4):284-8. doi: 10.1093/jjco/28.4.284.
Primary liposarcoma of the stomach is rare and only seven cases have been described in the English literature. Here we report the eighth case, which occurred in a 68-year-old woman who presented with repeated tarry stools and hematemesis. Endoscopic examination revealed a large ulcerated submucosal mass at the gastric angle. The patient was treated by total gastrectomy. On microscopic examination, the tumor showed the features of a well differentiated sclerosing liposarcoma. Immunohistochemically, many spindle to stellate tumor cells were diffusely positive for vimentin and CD34. Positivity for S-100 protein was found in the adipocytic component, including lipoblasts, in addition to some spindle-shaped tumor cells. On ultrastructural examination, the spindle to stellate cells had features characteristic of fibroblasts. No recurrence or metastasis was seen during 13 months. Liposarcoma of the stomach has to be considered in the differential diagnosis with other submucosal lesions, such as gastric lipoma and gastrointestinal stromal tumor.
原发性胃脂肪肉瘤罕见，英文文献中仅报道过7例。本文报告第8例，患者为一名68岁女性，表现为反复黑便和呕血。内镜检查发现胃角处有一个巨大的溃疡性黏膜下肿块。患者接受了全胃切除术。显微镜检查显示，肿瘤具有高分化硬化性脂肪肉瘤的特征。免疫组化显示，许多梭形至星状肿瘤细胞波形蛋白和CD34弥漫性阳性。除一些梭形肿瘤细胞外，脂肪细胞成分（包括脂母细胞）中S-100蛋白呈阳性。超微结构检查显示，梭形至星状细胞具有成纤维细胞的特征性表现。13个月内未见复发或转移。胃脂肪肉瘤在鉴别诊断中必须考虑与其他黏膜下病变，如胃脂肪瘤和胃肠道间质瘤相鉴别。
