消化道平滑肌肿瘤临床病理及形态学研究  

Clinicopathologic and morphologic study on smooth muscle tumors in alimentary tract

作　　者：侯英勇[1] 陶琨[2] 谭云山[3] 纪元[3] 周仲文[3] 郁敏 陆孝禹[4] 朱雄增[1] 

机构地区：[1]复旦大学附属肿瘤医院病理科,上海200032 [2]上海市长宁区中心医院病理科 [3]复旦大学附属中山医院病理科 [4]华东医院病理科

出　　处：《诊断病理学杂志》2002年第5期277-280,I075,共5页Chinese Journal of Diagnostic Pathology

基　　金：上海市科委资助项目。 (编号 9741190 2 5 )

摘　　要：目的　探讨消化道平滑肌肿瘤的临床病理及形态学特点 ,提供常规HE诊断的依据。方法　结合免疫组化和形态学观察 ,从 30 0余例消化道间叶源性肿瘤中确诊 4 5例消化道平滑肌肿瘤。结果　消化道平滑肌肿瘤最常发生于食管 ,其次为胃和直肠。其中食管固有肌层平滑肌瘤 2 0例 ,黏膜肌平滑肌瘤 7例 ,黏膜肌平滑肌肉瘤 1例 ;胃平滑肌瘤 12例 ,均为固有肌层 ;直肠平滑肌瘤 5例 ,其中黏膜肌平滑肌瘤 3例。随访 15例固有肌层平滑肌瘤 ,无肿瘤相关性死亡。镜下平滑肌瘤瘤细胞稀少或欠丰富 ,梭形 ,胞质丰富嗜伊红 ,交叉束状排列 ,偶见钙化及囊变。α SMA、MSA、desmin均弥漫强 (+) ,1例CD117局灶弱 (+) ,CD34均 (- )。平滑肌肉瘤瘤细胞丰富嗜伊红 ,细胞明显异型 ,有核分裂。结论　消化道平滑肌肿瘤少见 ,绝大部分为良性 ,恶性罕见 ;最常见于食管和胃 ,直肠也可发生。了解其临床病理特点有助于做出正确诊断。objective To explore the clinicopathologic features of smooth muscle tumors (SMTs) in alimentary tract for providing the evidences for routine morphologic diagnosis Methods Forty five cases of SMTs from over 300 cases of GIMTs were invistigated by combining immunohistochemical staining with morphologic analysis Results SMTs were the most common in esophagus, then in stomach and rectum 20 cases located in musclularis propria of esophagus, 7 cases located in musclularis mucosae, one case of leiomyosarcoma located in muscularis mucosae of esophagus, 12 cases of gastric LMTs, and 5 cases in rectum 15 cases of LMTs located in muscularis propria with followed up were clinically indolent without tumor related mortality Microscopically, LMTs showed sparse to low cellularity with eosinophinic abundant cytoplasm, and positive for desmin,α SMA, MSA, and negative for CD34 and CD117 (except one case showing local weak CD117 expression),and the tumor cells with variably eosinophilic cytoplasm showed nuclear pleomorphism and mitotic acitvity Conclusions Smooth muscle tumors are rare in alimentary tract, and most of them located in esophagus and presented clinically indolent It is important for the correct diagnosis to be familiar with the clinicopathologic features of SMTs.

关 键 词：消化道平滑肌肿瘤 临床病理 形态学 研究 

分 类 号：R735[医药卫生—肿瘤]