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目的探讨微囊/网状型神经鞘瘤的临床病理特征及鉴别诊断。方法对1例发生在胰腺的微囊/网状型神经鞘瘤进行HE和免疫组化染色检测,观察其形态学及免疫表型特点,并复习相关文献。结果患者中年男性,体检发现胰腺占位。肿块边界清楚,表面部分有包膜;切面实性,局灶黏液状。镜下呈网状、微囊状、假腺样或筛状结构,细胞异型性小,间质明显黏液变性和纤维化;灶性区域肿瘤累及包膜,但未见浸润周围正常组织。免疫组化:S-100、SOX10和CD56(+),CKpan和EMA(-)。结论微囊/网状型神经鞘瘤是一种与普通神经鞘瘤组织形态截然不同的肿瘤,应与胃肠道间叶性肿瘤和上皮性恶性肿瘤鉴别。
Objective To investigate the clinicopathological features and differential diagnosis of microcapsules / reticular schwannoma. Methods One case of microcapsules / reticular schwannoma occurred in the pancreas was examined by HE and immunohistochemistry. Morphological and immunophenotypic characteristics were observed. The related literatures were reviewed. Results Patients with middle-aged men, physical examination found pancreatic space. Clear mass boundary, the surface part of the envelope; section solid, focal mucus-like. Under the microscope, there were reticular, microcapsular, pseudo-gland-like or sieve-like structures with small cell atypia and obvious interstitial degeneration and fibrosis. Tumors in the focal area involved the capsule, but no normal tissues were infiltrated. Immunohistochemistry: S-100, SOX10 and CD56 (+), CKpan and EMA (-). Conclusions The microcapsules / reticular schwannoma is a tumor distinct from the normal schwannoma and should be distinguished from gastrointestinal mesenchymal tumors and epithelial malignancies.