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目的探讨食管炎性纤维性息肉临床病理特征、诊断与鉴别诊断。方法对1例食管炎性纤维性息肉病理组织学形态、免疫组化结果进行分析,并复习国内外相关文献。结果患者女性,67岁,2年前间断性咽部不适、有异物感,近1年咽部异物感加重,可随吞咽消失,偶感吞咽困难,1周前发生恶心、呕吐时见口腔内有肿物并有窒息感。食管内镜示食管入口处一息肉状肿物。镜检:肿瘤组织学形态见表面被覆鳞状上皮,其下方见梭形细胞、核细长略弯曲,或可见星芒状细胞,细胞质嗜酸有拖尾现象;散在少量细胞有异型,可伴有脂肪细胞成分,并伴有炎症细胞反应,病变内有丰富的厚薄不等小血管,周边可伴有瘤细胞围绕。免疫组化示肿瘤细胞vimentin、CD34和CD68(+),CD117、DOG-1、desmin、actin、S-100和Ki-67均(-)。结论食管发生炎性纤维性息肉极为罕见,组织学形态、免疫组化具有诊断价值,治疗方法根据肿瘤的大小、位置、基部有无蒂情况综合考虑,选择适宜的治疗方法。预后好。
Objective To investigate the clinicopathological features, diagnosis and differential diagnosis of esophagitis-like fibrillary polyps. Methods One case of esophageal fibroal fibrosis histopathology, immunohistochemistry results were analyzed and reviewed at home and abroad related literature. Results Female patient, 67 years old, 2 years ago interrupted pharyngeal discomfort, foreign body sensation, the past 1 years pharyngeal foreign body sensation aggravated, disappear with swallowing, dysphagia, dyspnea, nausea occurred 1 week ago, vomiting, see the oral cavity Tumor and suffocation. Esophageal endoscopic esophageal entrance to a polypoid mass. Microscopic examination: tumor histology see the surface covered with squamous epithelium, see the spindle cells below it, the nucleus elongated slightly curved, or visible asteroid cells, cytoplasm eosinophilic trailing phenomenon; scattered in a small amount of cells are abnormal, may be accompanied by There are fat cells, and accompanied by inflammatory cell response, the lesion is rich in blood vessels ranging from small blood vessels, peripheral can be associated with tumor cells around. Immunohistochemistry showed that the tumor cells vimentin, CD34 and CD68 (+), CD117, DOG-1, desmin, actin, S-100 and Ki-67 were all (-). Conclusion Esophageal inflammatory fibrotic polyps are extremely rare, histological morphology, immunohistochemistry has diagnostic value, the treatment method according to the size of the tumor, the location of the base with or without considering the situation, select the appropriate treatment. Good prognosis.