直肠炎性肌纤维母细胞性肿瘤临床病理观察  

Inflammatory myofibroblastic tumor of rectum: a clinicopathological analysis

作　　者：戴晓晓[1] 丁文燕[1] 

机构地区：[1]苏州市吴中人民医院病理科,江苏苏州215128

出　　处：《诊断病理学杂志》2014年第12期741-743,共3页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨直肠炎性肌纤维母细胞性肿瘤(IMT)的临床病理特征。方法对1例IMT进行临床、组织学和免疫组化观察,并复习相关文献。结果患者女性,36岁。临床表现为腹痛伴黏液血便半个月。肠镜检查示距肛门15 cm处可见5 cm×4 cm大小的息肉样肿块,表面高低不平。镜检:肿瘤组织主要由束状交错排列的梭形细胞组成,背景为黏液样基质及大量淋巴细胞、浆细胞浸润。免疫组化:梭形细胞vimentin、SMA和desmin(+),Ki-67阳性指数为20%,而ALK1、CD117、KP1、CD30、CD34、AE1/AE3、myogenin、H-caldesmon和HMB45均为(-)。术后随访18个月未复发。结论炎性肌纤维母细胞性肿瘤罕见于直肠,易被临床医师误诊为恶性肿瘤。免疫组化结果是该肿瘤与其他软组织肿瘤鉴别的重要依据。Purpose To investigate the clinicopathological features of inflammatory myofibroblastic tumor （IMT） in rectum. Methods A case of IMT in rectum was studied with histology and immunohistochemistry, followed by discussion through review of literatures. Results A 36-year-old female patient presented with half a month of abdominal pain and bloody stools. Endoscopic examination showed a 5 cm × 4 cm sized protruded tumor was located 5 cm away from anus edge. Histologically, the tumor was mainly composed of spindle cells with fascicular arrangement admixed with inflammatory cells, predominantly lymphocytes and plasma cells, and myxoid background. The tumor cells were immunoreactive to vimentin, SMA and desmin, but negative for ALK1, CDll7, KP1, CD30, CD34, AE1/AE3, myogenin, H-caldesmon and HMB45. There was no evidence of recurrence after a follow-up of 18 months. Conclusion IMT rarely occurs in rectum and it is easy to diagnose as carcinoma. Immunohistochemical phenotype is an important evidence to differentiate IMT from other soft tissue tumors.

关 键 词：炎性肌纤维母细胞性肿瘤 直肠 临床病理特征 

分 类 号：R735.3[医药卫生—肿瘤]