直肠碰撞瘤临床病理分析  

Clinicopathological analysis of collision tumor of rectal adenocarcinoma and neuroendocrine tumor

作　　者：曾艳[1] 李理[1] 汪芸[1] ZENG Yan;LI Li;WANG Yun(Department of Pathology,Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China)

机构地区：[1]中国中医科学院广安门医院病理科,北京100053

出　　处：《现代肿瘤医学》2024年第2期281-285,共5页Journal of Modern Oncology

摘　　要：目的:探讨直肠碰撞瘤的临床病理和免疫组化特征,提高对该病的诊断和鉴别诊断。方法:回顾性分析2例直肠碰撞瘤的临床病理资料,观察其组织学形态和免疫表型,并复习相关文献。结果:2例患者中,男性1例,女性1例,年龄分别为72岁和69岁,临床主要表现为便中带血、大便不尽、直肠肿块和排便习惯改变等表现。镜下可见肿瘤由中分化腺癌和神经内分泌肿瘤(NET G1)碰撞形成。免疫组化:腺癌细胞MLH1(+)、MSH2(+)、MSH6(+)、PMS2(+),神经内分泌肿瘤细胞CD56(+)、CgA(+)、Syn(+)。结论:直肠腺癌和神经内分泌肿瘤形成的碰撞瘤很少见,临床表现缺乏特异性,临床及病理医师应当充分认识该病,避免延误诊断和治疗。Objective:To analyze the clinicopathological and immunohistochemical characteristics of rectal collision tumor and hence to improve the level of diagnosis and differential diagnosis for the disease.Methods:We have selected 2 cases of rectal collision tumor in our department for the study,with 1 male and 1 female,and patients'age was 69 and 72 years old,respectively.Results:Upon retrospective analysis of their similar findings in other literature,the study showed that hematochezia,tenesmus,rectal mass and change in stool habits were the primary clinical symptoms.Microscopically,collision tumors constituted by moderately differentiated adenocarcinoma and neuroendocrine tumor(NET G1)located in the rectum.Immunohistochemically,the adenocarcinoma cells showed positive reactivity to MLH1,MSH2,MSH6 and PMS2,the NET cells showed positive reactivity to CD56,CgA and Syn.Conclusion:Collision tumor of rectal is a rare neoplasm and its clinical presentation is not very unique.Therefore,a high digree of clinical suspicion is required to avoid delays in diagnosis and treatment.

关 键 词：碰撞瘤 直肠 腺癌 神经内分泌肿瘤 

分 类 号：R735.3[医药卫生—肿瘤]