胃重复囊肿合并原发性腺癌临床病理观察  

Clinicopathological feature of adenocarcinoma arising from gastric duplication cyst

作　　者：王翠翠[1] 景洪标[1] 刘晓红[1] 曹永成[1] 耿明[1] 

机构地区：[1]济南军区总医院病理科,济南250031

出　　处：《诊断病理学杂志》2014年第4期228-230,共3页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨胃重复囊肿合并原发性腺癌的临床病理特征。方法分析1例胃重复囊肿合并原发性腺癌的临床资料、影像学改变及病理组织学特征,并结合文献讨论。结果肿瘤位于左上腹脾胃韧带间,大小8 cm×8 cm×6 cm,呈类圆形,与胃大弯浆膜层紧密相连,但与胃腔不相通。肿瘤呈囊性,壁厚、充满黏稠物质,基底部与大弯相连约6 cm。镜下囊性肿块内衬胃黏膜,有发育良好的囊壁,依次为黏膜层、黏膜下层、肌层和浆膜层;部分区域发生癌变,病理诊断为"中分化腺癌,侵及囊壁浆膜层和胃肌层"。结论胃重复囊肿是一种罕见的先天性发育异常性疾病,发生恶性肿瘤非常罕见,大多数为腺癌,少数为鳞癌。为防止恶变,重复囊肿即使无症状也应及时手术切除。Objective To investigate the clinical and pathological features of adenoearcinoma arising duplication cyst. Methods The clinical data of one male patient （25 years old） with ad from a gastric arising from a gastric duplication cyst were presented and discussed, with review of the literature, including the imaging and histopathologic features. Results The tumor, about 8 cm × 8 cm × 6 cm in size, centered in the region of the gastrosplenic ligament, in contact with the greater curvature of the stomach, but not associated with the gastric cavity. The tumor was cystic, wall thickness and full of a thick gelatinous, greenish-yellow substance. Microscopic examination revealed that the cystic mass had a well-formed cystic wall with an inner mucosal lining, a submucosal layer, muscularis propria with inner and outer smooth muscle layers, corresponding to the muscularis propria of the stomach, and an outer serosal layer. In some regions of the cystic wall, the submucosal layer was absent and the carcinoma had invaded the serosa of the cyst wall and the gastric muscular wall adjacent to the duplication cyst. The diagnosis was moderately differentiated tubular carcinoma. Conclusion Gastric duplications are uncommon congenital abnormalities. Malignant transformation in a gastric duplication cyst （GDC） is extremely rare and adenocarcinoma is the most common type. Strict morphological criteria have been established for the correct diagnosis of alimentary tract duplications. It is recommended that once a duplication cyst has been diagnosed, even an asymptomatic one, it should be removed because of the risk of malignant changes. Complete resection of the duplication should be the procedure of choice.

关 键 词：胃重复囊肿 胃腺癌 临床病理特征 

分 类 号：R735.2[医药卫生—肿瘤]