胃早期嗜酸细胞性神经内分泌肿瘤伴淋巴结转移1例  

Early gastric oncocytic neuroendocrine tumor with lymph node metastasis:a case report

作　　者：侯卫华 段心科 石中月 张萌 李永坚 程雪燕 司志方 张利明 金木兰[3] Hou Weihua;Duan Xinke;Shi Zhongyue;Zhang Meng;Li Yongjian;Cheng Xueyan;Si Zhifang;Zhang Liming;Jin Mulan(Department of Pathology,Xiangcheng County People′s Hospital,Xiangcheng,461700,China;Department of Gastroenterology,989 Hospital of Joint Logistic Support Force,Pingdingshan 467099,China;Department of Pathology,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China;Department of Pathology,989 Hospital of Joint Logistic Support Force,Pingdingshan 467099,China;Departments of Radiology,989 Hospital of Joint Logistic Support Force,Pingdingshan 467099,China)

机构地区：[1]河南省许昌市襄城县人民医院病理科,襄城461700 [2]联勤保障部队第九八九医院消化内科,平顶山467099 [3]首都医科大学附属北京朝阳医院病理科,北京100020 [4]联勤保障部队第九八九医院病理科,平顶山467099 [5]联勤保障部队第九八九医院放射科,平顶山467099

出　　处：《中华转移性肿瘤杂志》2024年第3期240-244,共5页Chinese Journal of Metastatic Cancer

基　　金：国家自然科学基金(62176168);中国消化道早癌医师共同成长计划科研专项基金(GTCZ-2023-HN-01)。

摘　　要：本文报道1例胃早期嗜酸细胞性神经内分泌肿瘤(NET)伴淋巴结转移。患者男,65岁,因胸部外伤行内镜和CT检查发现胃窦体交界黏膜早期病变和胃壁外侧肿大淋巴结,遂行腹腔镜下胃部分切除术。组织学上,胃内肿瘤细胞胞质丰富嗜酸性,核轻度增大,核分裂罕见,细胞排列呈腺管状至实性片状。肿瘤具有神经内分泌免疫表型,Ki-67阳性指数2%。胃壁外侧淋巴结转移性肿瘤除与胃内肿瘤组织形态和免疫表型相同外,还可见小灶状普通型胃腺癌。本例患者选择了观察等待,目前已随访14个月,其长期预后有待进一步跟踪观察。该案例表明胃嗜酸细胞性NET具有多向分化潜能和生物行为的不确定性,目前的消化系统NET分级标准可能不适合用于具有嗜酸细胞性特征的NET。A case of early gastric oncocytic neuroendocrine tumor(NET)with lymph node metastasis was reported.The patient,a 65 year-old male,underwent laparoscopic partial gastrectomy due to chest trauma and found early mucosal lesions at the junction of the antrum body and enlarged lymph nodes on the lateral side of the gastric wall by endoscopic and CT examinations.Histologically,the eosinophilic cytoplasm of tumor cells in the stomach is rich,the nucleus is slightly enlarged,and mitosis is rare.The cells are arranged from glandular tubular to solid flakiness.The tumor has neuroendocrine immunophenotype,with Ki-67 positive index of 2%.The metastatic tumors of lateral gastric lymph nodes have the same histomorphology and immunophenotype as the intragastric tumors,and small flaky ordinary gastric adenocarcinoma can also be seen in the tumor.In this case,the patient has been followed up for 14 months,and his long-term prognosis needs further follow-up.This case showed that gastric oncocytic NET has multi-directional differentiation potential and uncertainty of biological behavior.The current NET classification standard of digestive system may not be suitable for NET with eosinophilic characteristics.

关 键 词：胃癌 神经内分泌肿瘤 类癌 嗜酸细胞类癌 

分 类 号：R735.2[医药卫生—肿瘤]