消化道颗粒细胞瘤九例分析及文献复习
|
摘要
目的探讨消化道颗粒细胞瘤的临床病理学特点、鉴别诊断、治疗及预后。方法收集并回顾性分析北京友谊医院2009年至2016年间诊断的9例消化道颗粒细胞瘤的临床特点、组织形态学及免疫表型特点,并复习相关文献。结果研究共纳入9例患者,其中男性5例,女性4例;年龄39~67岁,平均年龄52±9岁。肿物直径0.2~1.2cm,平均直径0.56±0.28 cm。9例患者治疗均采用内镜下黏膜切除术。显微镜下肿瘤呈浸润性生长,瘤细胞排列成巢状或片状,胞质丰富、嗜酸性,核小位于细胞中央。未见坏死及核分裂。免疫组化肿瘤细胞表达S-100、CD68、Vimentin。结论消化道颗粒细胞瘤是一种少见的神经源性肿瘤,主要发生在食管,少见发生在胃及结肠。确诊需要依靠病理形态学及免疫组织化学。推荐的治疗方法是内镜下黏膜切除术。
Objective To explore the clinicopathological features,differential diagnosis and treatment of granular cell tumor in digestive tract. Methods Nine cases of granular cell tumor in digestive tract diagnosed in this hospital during 2009 to 2016 were collected for this study.The clinical characteristics,pathological features and immunological expressioin were analyzed,and their morphological features were studied by gross examination,light microscopy and immunohistochemical exaination,and accompanied with review of related literatures. Results Five cases were males and four females,the average age of these patients was 52 ± 9 years old( with age range of 39 to 67 years old). The size of tumors ranged from 0. 2 to 1. 2 cm in greatest dimension,and their average diameter was 0. 56 ± 0. 28 cm. All these patients received endoscopic mucosal endoscopical resection,the growth pattern was nested or solid with infiltrative margin,tumor cells had abundant eosinophilic cytoplasm with a small central nucleus,mitosis and necrosis were absent in all cases. Immunohistochemically,all cases showed positive for S-100,CD68 and Vimentin expression. Conclusion Granular cell tumor in digestive tract is a rare neoplasm of neural derivation,most commonly occur in esophageal,rarely occur in stomach and colon. Its dignosis depends on pathomorphological examination and immunophenotyping. Endoscopic mucosal resection is recommended as a therapeutic method.
Objective To explore the clinicopathological features,differential diagnosis and treatment of granular cell tumor in digestive tract. Methods Nine cases of granular cell tumor in digestive tract diagnosed in this hospital during 2009 to 2016 were collected for this study.The clinical characteristics,pathological features and immunological expressioin were analyzed,and their morphological features were studied by gross examination,light microscopy and immunohistochemical exaination,and accompanied with review of related literatures. Results Five cases were males and four females,the average age of these patients was 52 ± 9 years old( with age range of 39 to 67 years old). The size of tumors ranged from 0. 2 to 1. 2 cm in greatest dimension,and their average diameter was 0. 56 ± 0. 28 cm. All these patients received endoscopic mucosal endoscopical resection,the growth pattern was nested or solid with infiltrative margin,tumor cells had abundant eosinophilic cytoplasm with a small central nucleus,mitosis and necrosis were absent in all cases. Immunohistochemically,all cases showed positive for S-100,CD68 and Vimentin expression. Conclusion Granular cell tumor in digestive tract is a rare neoplasm of neural derivation,most commonly occur in esophageal,rarely occur in stomach and colon. Its dignosis depends on pathomorphological examination and immunophenotyping. Endoscopic mucosal resection is recommended as a therapeutic method.
引文
[1]Patti R,Almasio PL,Di Vita G.Almasio and G.Di Vita,Granular cell tumor of stomach:a case report and review of literature[J].World JGastroenterol,2006,12(21):442-445.
[2]Hong R,Lim SC.Granular cell tumor of the cecum with extensive hyalinization and calcification:a case report[J].World J Gastroenterol,2009,15(26):3315-3318.
[3]Cha JM,Lee JI,Joo KR,et al.Granular cell tumor of the descending colon treated by endoscopic mucosal resection:a case report and review of the literature[J].J Korean Med Sci,2009,24(2):337-341.
[4]Huang AT,Dominguez LM,Powers CN,et al.Granular cell tumor of the cervical esophagus:case report and literature review of an unusual cause of Dysphagia[J].Head Neck Pathol,2013,7(3):274-279.
[5]Nie L,Xu G,Wu H,et al.Granular cell tumor of the esophagus:a clinicopathological study of 31 cases[J].Int J Clin Exp Pathol,2014,7(7):4000-4007.
[6]Berzal Cantalejo MF,González Medina AR,Torío Sánchez B.Granular cell tumor of cecum[J].Rev Esp Enferm Dig,2016,108(6):364-365.
[7]Riffle ME,Polydorides AD,Niakan J,et al.Eosinophilic Esophagitis and Esophageal Granular Cell Tumor:An Unexpected Association[J].Am J Surg Pathol,2017,41(5):616-621.
[8]Aoyama K,Kamio T,Hirano A,et al.Granular cell tumors:a report of six cases[J].World J Surg Oncol,2012,10:204.
[9]Komori K,Akahoshi K,Tanaka Y,et al.Endoscopic submucosal dissection for esophageal granular cell tumor using the clutch cutter[J].World J Gastrointest Endosc,2012,4(1):17-21.
[10]Lu W,Xu MD,Zhou PH,et al.Endoscopic submucosal dissection of esophageal granular cell tumor[J].World J Surg Oncol,2014,12:221.
[2]Hong R,Lim SC.Granular cell tumor of the cecum with extensive hyalinization and calcification:a case report[J].World J Gastroenterol,2009,15(26):3315-3318.
[3]Cha JM,Lee JI,Joo KR,et al.Granular cell tumor of the descending colon treated by endoscopic mucosal resection:a case report and review of the literature[J].J Korean Med Sci,2009,24(2):337-341.
[4]Huang AT,Dominguez LM,Powers CN,et al.Granular cell tumor of the cervical esophagus:case report and literature review of an unusual cause of Dysphagia[J].Head Neck Pathol,2013,7(3):274-279.
[5]Nie L,Xu G,Wu H,et al.Granular cell tumor of the esophagus:a clinicopathological study of 31 cases[J].Int J Clin Exp Pathol,2014,7(7):4000-4007.
[6]Berzal Cantalejo MF,González Medina AR,Torío Sánchez B.Granular cell tumor of cecum[J].Rev Esp Enferm Dig,2016,108(6):364-365.
[7]Riffle ME,Polydorides AD,Niakan J,et al.Eosinophilic Esophagitis and Esophageal Granular Cell Tumor:An Unexpected Association[J].Am J Surg Pathol,2017,41(5):616-621.
[8]Aoyama K,Kamio T,Hirano A,et al.Granular cell tumors:a report of six cases[J].World J Surg Oncol,2012,10:204.
[9]Komori K,Akahoshi K,Tanaka Y,et al.Endoscopic submucosal dissection for esophageal granular cell tumor using the clutch cutter[J].World J Gastrointest Endosc,2012,4(1):17-21.
[10]Lu W,Xu MD,Zhou PH,et al.Endoscopic submucosal dissection of esophageal granular cell tumor[J].World J Surg Oncol,2014,12:221.