消化道颗粒细胞瘤9例临床分析  

Clinical Analysis of 9 Cases of Granular Cell Tumor of Gastrointestinal Tract

作　　者：吴晨霞[1] 施红旗[2] 崔海宏[3] 黄斌[4] 张宝燕[1] 苏杰 姜春婷 邱岳琳 WU Chenxia;SHI Hongqi;CUI Haihong;HUANG Bin;ZHANG Baoyan;SU Jie;JIANG Chunting;QIU Yuelin(Department of Pathology,the 903rd Hospital of Joint Logistics Support Force,PLA,Hangzhou 310013;Department of Pathology,Jinhua Municipal Central Hospital Medical Group,Jinhua,Zhejiang Province;Department of Gastroenterology,the 305th Hospital of PLA,Beijing;Department of Pathology,the First People’s Hospital of Xiaoshan,Hangzhou)

机构地区：[1]中国人民解放军联勤保障部队第903医院病理科,310013 [2]金华市中心医院医疗集团(医学中心)病理科 [3]中国人民解放军第305医院消化科 [4]杭州市萧山区第一人民医院病理科

出　　处：《胃肠病学》2021年第10期594-598,共5页Chinese Journal of Gastroenterology

摘　　要：背景:颗粒细胞瘤(GCT)少见,消化道GCT更少见。目的:探讨消化道GCT的临床病理学特点及其治疗和预后。方法:收集2017年1月-2021年6月联勤保障部队第903医院和金华市中心医院医疗集团(医学中心)收治的9例消化道GCT患者,回顾性分析患者的临床资料、病理学特征及其治疗方案和预后。结果:9例消化道GCT患者中,男女之比为2∶1;发病年龄为19~60岁,中位年龄52岁;发生于食管6例,结直肠2例,肛管1例。内镜示黏膜下隆起或无蒂息肉,肿瘤直径2~12 mm,中位直径5 mm。组织病理学检查示肿瘤位于黏膜层和(或)黏膜下层,呈实性团片状或巢状排列,周边呈浸润性生长;间质有炎性细胞浸润;瘤细胞呈胖梭形或多边形,胞质丰富,内含大量嗜酸性颗粒;核小、核质比极低,核分裂象罕见。免疫组化示所有患者均表达S100和CD68,部分表达SOX10、CD56、Calretinin和Syn,不表达CKp、Desmin、SMA、CD117、CD34、Dog1和α-inhibin。食管和结直肠GCT均行内镜下黏膜切除术(EMR)或内镜黏膜下剥离术(ESD),肛管GCT行局部切除术。所有患者随访9~53个月,均未见肿瘤复发或转移。结论:消化道GCT少见,临床症状无特异性,内镜下多呈黏膜下隆起或无蒂息肉,有特征性病理形态和免疫表型。病变小且浅表者行EMR或ESD治疗,效果好,术后需长期随访。Background: Granular cell tumor(GCT) is an uncommon tumor, and gastrointestinal tract GCT is even more rare. Aims: To investigate the clinicopathological characteristics, treatment and prognosis of gastrointestinal tract GCT. Methods: Nine cases of gastrointestinal tract GCT from January 2017 to June 2021 at the 903 rd Hospital of Joint Logistics Support Force, PLA and Jinhua Municipal Central Hospital Medical Group were retrieved. The clinical data, histopathological characteristics, treatment, and prognosis were retrospectively analyzed. Results: In the 9 patients with gastrointestinal tract GCT, ratio of male to female was 2∶1, age at diagnosis was 19-60 years, with a median age of 52 years. Six GCT were found in esophagus, 2 in colorectum and 1 in anus. Endoscopic results showed submucosal protrusion or sessile polyps ranging in size from 2-12 mm with a median of 5 mm. Histology results showed that tumors were located in mucosa and/or submucosa, arranged in solid sheets or nests, with an infiltrative margin and inflammatory infiltrates. Tumor cells were mainly plump and polygonal with abundant cytoplasm and eosinophilic granules. Nuclei were small, the nuclear-cytoplasmic ratio was very low. Mitotic figure was rare. Immunohistochemistry results showed that S100 and CD68 proteins were positive in all patients, SOX10, CD56, Calretinin and Syn were positive in some patients, and CKp, Desmin, SMA, CD117, CD34, Dog1, and α-inhibin were negative in all patients. Esophageal and colorectal GCT patients received endoscopic mucosal resection(EMR) or endoscopic submucosal dissection(ESD). The anal GCT patient underwent local resection. Recurrence or metastasis were not observed during 9-53 months of follow-up. Conclusions: Gastrointestinal tract GCT is rare with non-specific clinical symptoms and submucosal protrusion or sessile polyps under endoscopy. Gastrointestinal tract GCT has special pathomorphology and immunophenotype. EMR or ESD is recommended for small and superficial lesions. Long-term follow-up should be

关 键 词：颗粒细胞瘤 诊断 治疗 预后 

分 类 号：R735[医药卫生—肿瘤]