胃钙化性纤维性肿瘤2例临床病理观察  

Gastric calcifying fibrous tumor: a clinicopathologic analysis of 2 cases

作　　者：李兆丽[1] 李青[1] 吴晁[1] 鲁常青[1] 谈炎[1] 虞华明[1] 

机构地区：[1]常州市第一人民医院病理科,江苏常州213003

出　　处：《诊断病理学杂志》2014年第5期301-303,307,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨胃钙化性纤维性肿瘤(CFT)的临床病理特征、免疫表型及鉴别诊断。方法回顾性分析2例胃CFT的临床资料、病理组织学及免疫组化检测结果,并进行文献复习。结果 2例胃CFT胃镜下均表现为胃体部息肉样黏膜下隆起性病变,最大径分别为1.5 cm和1.2 cm。镜下特点为胶原玻璃样变的纤维组织内伴有钙化或砂砾体形成,其间夹杂稀疏的梭形纤维母细胞,间质内可见散在或灶性的淋巴细胞和浆细胞浸润。免疫组化显示梭形细胞vimentin(+),Pgp 9.5、SMA、desmin、CD34、CD117、DOG-1、S-100、AE1/AE3、Ki-67和ALK1均(-)。结论胃CFT是一种极少见的良性纤维性肿瘤,其诊断主要依靠组织形态学及免疫组化。需注意与发生于胃壁的其他间叶源性肿瘤如胃肠间质瘤、神经鞘瘤、纤维瘤病、孤立性纤维性肿瘤、炎性肌纤维母细胞瘤等相鉴别。Objective To investigate the clinicopathological characteristics, immunophenotype and differential diagnosis of gastric calcifying fibrous tumor （CFT）. Methods The clinical data, histopathological and immunohistochemical features were retrospectively analyzed in 2 cases of gastric CFT and the related literatures were reviewed. Results Gastroscopy revealed a polypoid submucosal bulge in the gastric corpus with a maximum distension of 1.5 cm and 1.2 cm, respectively. Microscopically, the tumor showed characteristic hypocellular hyalinized and fibrosclerotic tissue with coarse collagen, psammomatous calcifications, sparse fibroblastic spindle cells and scattered or foci lymphoplasmacytic infiltrates. Immunohistochemically, the spindle cells were positive for vimentin and negative for Pgp 9.5, SMA, desmin, CD34, CDll7, DOG-l, S-100, AE1/AE3, Ki-67 and anaplastic lymphoma kinase - I（ALK1）. Conclusion Gastric CFT is a very rare benign fibrous tumor. The diagnosis of gastric CFT should be based on the characteristic morphologic changes and immunohistochemical findings. The differential diagnosis of gastric FT includes other gastric mesenchymal neoplasms such as gastrointestinal stromal tumor, schwannoma, fibromatosis, solitary fibrous tumor, and inflammatory myofibroblastic tumor.

关 键 词：胃肿瘤 钙化性纤维性肿瘤 鉴别诊断 

分 类 号：R735.2[医药卫生—肿瘤]