消化道神经鞘瘤临床病理特征及鉴别诊断
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摘要
目的分析消化道神经鞘瘤的临床病理特征,并予以鉴别诊断。方法回顾性分析2010年1月—2018年7月本医院治疗的10例消化道神经鞘瘤患者的临床病理特征。结果病理大体巨检结果 :直径均值4cm,不具有包膜,周界较清楚4例,周界欠清楚6例。累及黏膜表面和浆膜下层2例,累及黏膜下层和肌层之内2例,累及肌层6例。肿瘤切面实性,质地较韧。镜检结果 :瘤细胞为长梭形,小束状,大多编织状结构。免疫组化结果 :vimentin及S-100阳性(+),1例少数瘤细胞CD34(+),5例PAS及Masson(-)。结论消化道神经鞘瘤存在一定临床病理特征,需依据组织学及免疫组化诊断。
Objective To analyze the clinicopathological features of neurilemmoma of the digestive tract and to provide differential diagnosis.Methods The clinical and pathological features of 10 patients with gastrointestinal schwannoma treated in our hospital from January 2010 to July 2018 were analyzed retrospectively. Results The results of pathological macroscopical examination showed that the mean diameter was 4 cm, there was no capsule, the periphery was clear in 4 cases, and the periphery was not clear in 6 cases. 2 cases involved mucosal surface and submucosal layer, two cases involved submucosal layer and muscular layer, and six cases involved muscular layer. The tumors are solid in section and tough in texture. Microscopic examination showed that the tumor cells were spindleshaped, fascicular and mostly braided. Immunohistochemical results showed that vimentin and S-100 were positive(+), CD34(+) in 1 case,PAS and Masson(-) in 5 cases. Conclusion Neurilemmoma of digestive tract has certain clinicopathological features, which should be diagnosed by histology and immunohistochemistry.
Objective To analyze the clinicopathological features of neurilemmoma of the digestive tract and to provide differential diagnosis.Methods The clinical and pathological features of 10 patients with gastrointestinal schwannoma treated in our hospital from January 2010 to July 2018 were analyzed retrospectively. Results The results of pathological macroscopical examination showed that the mean diameter was 4 cm, there was no capsule, the periphery was clear in 4 cases, and the periphery was not clear in 6 cases. 2 cases involved mucosal surface and submucosal layer, two cases involved submucosal layer and muscular layer, and six cases involved muscular layer. The tumors are solid in section and tough in texture. Microscopic examination showed that the tumor cells were spindleshaped, fascicular and mostly braided. Immunohistochemical results showed that vimentin and S-100 were positive(+), CD34(+) in 1 case,PAS and Masson(-) in 5 cases. Conclusion Neurilemmoma of digestive tract has certain clinicopathological features, which should be diagnosed by histology and immunohistochemistry.
引文
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[2]赵怡璇,刘爽,胡艳兵,等.消化道黏膜下肿物在超声内镜下的表现特征[J].现代消化及介入诊疗,2016,21(6):803-806.
[3]朱向超,金明新,刘帆,等.胃肠道神经鞘瘤的诊断与治疗[J].中华普通外科杂志,2016,31(6):472-474.
[4]邱云峰,杜琪威,杨维良,等.胃神经鞘瘤的临床特点及诊治(附21例报告)[J].腹部外科,2015(1):44-46,49.
[5]彭涛,娄展,赵轶峰,等.双镜联合治疗胃丛状神经鞘瘤[J].中华胃肠外科杂志,2017,20(7):829-830.
[6]解桢,李天月,张连国,等.食管巨大神经鞘瘤1例[J].中华胸心血管外科杂志,2016,32(5):304-305.
[7]黄侃,陈保俊.食管黏膜下神经鞘瘤一例[J].中国综合临床,2017,33(11):1042-1043.
[8]陈先凯,李印,刘先本,等.胸腔镜治疗食管神经鞘瘤1例[J].中华胸心血管外科杂志,2015,31(5):307.
[9]李舒杰.胃神经鞘瘤多层螺旋CT诊断与临床治疗[J].中国现代药物应用,2015,9(20):93-94.
[10]张庆斌,孙勇攀,金星,等.食管神经鞘瘤1例并文献复习[J].甘肃医药,2016,35(12):938-940.
[11]何明燕,张嵘,翟凤仪,等.胃肠道神经鞘瘤与胃肠间质瘤CT征象的比较研究[J].中华胃肠外科杂志,2015,18(10):1020-1025.
[12]王军燕,孙延豹.胃神经鞘瘤的CT表现[J].医学影像学杂志,2015,25(5):815-817.