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目的探讨胃血管球瘤的临床病理特征、诊断和鉴别诊断。方法对4例胃血管球瘤行组织学观察和免疫组织化学分析,并复习相关文献。结果肿物位于胃窦或胃体黏膜下,直径1.5~3 cm。显微镜下肿瘤组织在胃肌壁间呈多结节状分布;结节内肿瘤细胞小-中等大小,圆形、多角形,胞界清楚,胞质丰富红染或空亮,细胞核圆形、卵圆形居中,无明显异型性到轻度异型,核分裂像罕见;瘤组织内富含血管,部分瘤细胞围绕分枝状的血管形成血管外皮瘤样结构;部分瘤细胞呈实性分布。免疫组织化学肿瘤细胞vimentin、平滑肌肌动蛋白(smooth muscle antigen,SMA)、actin及层粘连蛋白(laminin,LN)阳性;CK、CD34、CD117、DOG-1、CgA、Syn、S-100、HMB45、Melan-A等阴性。结论胃血管球瘤非常少见,大多数生物学行为表现为良性。确诊需结合组织病理学形态和免疫表型综合分析,需与胃肠间质瘤及神经内分泌肿瘤等鉴别。
Objective To investigate the clinicopathological features, diagnosis and differential diagnosis of gastric gliomas. Methods Four cases of gastric gliomas were observed by histology and immunohistochemistry, and the related literatures were reviewed. Results The tumor located in the antrum or corpus mucosa, diameter 1.5 ~ 3 cm. Microscopic tumor tissue in the gastric mucosa were multi-nodular distribution; nodular tumor cells small - medium size, round, polygonal, clear boundary, rich cytoplasm of red dye or empty, round nucleus, eggs Round center, no obvious atypia to mild dysplasia, mitotic figures rare; tumor tissue is rich in blood vessels, some tumor cells around the dendritic blood vessels to form vascular endothelial tumor-like structure; part of the tumor cells were solid distribution. Immunohistochemical staining of vimentin, smooth muscle actin (SMA), actin and laminin (LN) were positive in CK, CD34, CD117, DOG-1, CgA, Syn, S-100 and HMB45 , Melan-A negative. Conclusions Gastric gliomas are rare and most of their biological behavior is benign. Diagnosis should be combined with histopathological morphology and immunophenotype comprehensive analysis, need and gastrointestinal stromal tumors and neuroendocrine tumors and other identification.