胃炎性肌纤维母细胞肿瘤的临床病理观察  

Primary gastric inflammatory myofibroblastic tumor: a clinicopathologic study

作　　者：刘毅强[1,2] 徐丹[3] 黄小征[1,2] 周立新[1,2] 薛卫成[1,2] 

机构地区：[1]北京大学肿瘤医院 [2]北京市肿瘤防治研究所病理科/恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142 [3]湖北省松滋市人民医院病理科,松滋434200

出　　处：《临床与实验病理学杂志》2015年第2期164-168,共5页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的：探讨胃炎性肌纤维母细胞肿瘤（ inflammatory myofibroblastic tumor, IMT）的临床病理学特征、诊断及鉴别诊断。方法对4例胃IMT进行免疫组化和原位杂交检测,并复习相关文献。结果4例胃IMT中男性2例,女性2例,年龄21～51岁,肿瘤直径1．5～6．5 cm。镜下见肿瘤由多少不等的梭形肿瘤细胞及淋巴细胞、浆细胞、嗜酸性粒细胞构成,伴有黏液样或胶原化间质,甚至可出现钙化及骨化。大部分肿瘤细胞形态温和,部分细胞轻度不典型性,核分裂象1～2个/10 HPF。免疫表型：4例SMA均阳性,2例ALK阳性,1例CD34局灶阳性,S-100、desmin、CD68、CD117和DOG1均阴性。4例胃IMT患者随访24～66个月,均无复发及转移。结论胃IMT是一种比较少见的具有独特病理学改变的交界性肿瘤,需与多种梭形细胞肿瘤相鉴别,少数病例具有复发倾向及恶变潜能。Purpose To investigate the clinicopathologic features, diagnosis and differential diagnosis of primary gastric inflammatory myofibroblastic tumor （ IMT） . Methods Four cases of gastric IMTs were studied by clinicopathologic analysis, immunohistochemistry and in situ hybridization, and the related literature was reviewed. Results In four cases there are two males and two females, age range from 21 to 51 years old, and tumor size ranged from 1. 5 to 6. 5 cm in the greatest dimension. Histologically, these tumors were composed of varied spindle cells and chronic inflammatory cells, in a myxoid or hyalinized stroma. Occasionally, there were calcifica-tion and ossification areas. Most of the spindle cells had bland appearance and a minority of the tumor cells showed mild atypia. One to two mitotic figures were recognized in 10 high power fields （ HPFs） in 1 to 2 patients. Smooth muscle actin staining was observed in all tumors and ALK staining observed in two tumors. One tumor focally expressed CD34. S-100, desmin, CD68, CD117 and DOG1 was negative in all IMTs. The patients were followed up from 24 to 66 months, and none of them had tumor relapsed or metastasis. Conclu-sions Primary gastric IMTs have an intermediate behavior, and a few cases have malignant potential. It should be distinguished from other spindle cell lesions similar to IMT.

关 键 词：胃肿瘤 炎性肌纤维母细胞肿瘤 临床病理 鉴别诊断 

分 类 号：R735.2[医药卫生—肿瘤]