伴有横纹肌样特征的低分化胃腺癌临床病理观察  

Anaplastic adenocarcinoma of the stomach with rhabdoid phenotype: a clinicopathologic study of one case and review of literature

作　　者：隋燕霞[1] 王鸿雁[1] 禄韶英[2] 党诚学[3] 宋永春[3] 张晓智[4] 韩苏夏[4] 赵东利[4] 

机构地区：[1]西安交通大学第一附属医院病理科,西安710061 [2]西安交通大学第一附属医院外科,西安710061 [3]西安交通大学第一附属医院肿瘤外科,西安710061 [4]西安交通大学第一附属医院肿瘤放疗科,西安710061

出　　处：《诊断病理学杂志》2016年第3期194-196,201,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨伴有横纹肌样特征的低分化胃腺癌的临床病理特征、诊断与鉴别诊断,以提高对本肿瘤的认识。方法应用光镜和免疫组化染色对1例罕见的伴有横纹肌样特征的低分化胃腺癌进行观察,并复习相关文献。结果镜下伴有横纹肌样特征的肿瘤细胞弥漫片状或腺泡状排列,侵犯胃壁全层。肿瘤细胞黏附性差,呈类圆形或不规则形,胞质丰富,强嗜酸性,可见红染均质包涵体,核泡状、偏位,核仁突出,核分裂象易见。免疫组化肿瘤细胞vimentin弥漫(+),CAM5.2部分(+),Muc-5AC灶状(+),Ki-67增殖指数80%。结论伴有横纹肌样特征的低分化胃腺癌是极为罕见的高度恶性肿瘤,特征性的组织学形态及免疫组化标记有助于诊断与鉴别诊断。Objective To study the clinicopathologic features, diagnosis, differential diagnosis of the anaplastic adenostomach carcinoma with rhabdoid features in order to improve understanding of the tumor. Methods One rare case of stomach anaplastic adenocarcinoma with rhabdoid features was studied by histology and immunohistochemistry,and review of relevant literatures. Results The adenocarcinoma with rhabdoid cells represented diffuse sheet or acinar pattern,with full-thickness invasion into the wall of the stomach. Tumor cell adhesion was poor,oval or irregular shape and characterized by abundant and strongly eosinophilic cytoplasm contained eosinophilic hyaline inclusions with eccentric,vesicular nuclei,prominent nucleoli and mitoses. Immunohistochemically,the rhabdoid cells were diffusely positive for wimentin,partially positive for CAM5. 2,focally positve for Muc-5AC. The Ki-67 labeling index was high,about 80%.Conclusions The stomach anaplastic adenocarcinoma with rhabdoid features is rare with highly aggressive behavior. Its diagnosis and differential diagnosis are established on the characteristic morphological features and immunohistochemical findings.

关 键 词：胃腺癌 横纹肌样 临床病理学 免疫组化 

分 类 号：R736.1[医药卫生—肿瘤]