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目的探讨胃嗜酸性肉芽肿的临床病理特征及误诊的原因。方法收集2例胃嗜酸性肉芽肿和6例胃间质瘤的临床及病理资料,组织蜡块作HE染色,免疫组化作Desm in、vim entin、SMA、S100、CD34、CKp染色。结果胃嗜酸性肉芽肿和胃间质瘤的临床改变相似、不易区分。组织学改变不同,胃嗜酸性肉芽肿梭形细胞分布不均匀,间有少量的淋巴细胞,散在的嗜酸性粒细胞和Langerhans细胞,而胃间质瘤由分布均匀的长梭形细胞构成,无炎症细胞。免疫组化胃嗜酸性肉芽肿梭形细胞vim entin阳性,Langerhans细胞S100阳性。胃间质瘤梭形细胞CD34、V im entin阳性,Desm in、SMA、S100、CKp均阴性。结论胃嗜酸性肉芽肿的确诊依据组织学改变及免疫组化染色,是一种病程长不能自愈的良性病变,可能癌变,手术治疗有效。
Objective To investigate the clinicopathological features and misdiagnosis of gastric eosinophilic granuloma. Methods Clinical and pathological data of 2 cases of gastric eosinophilic granuloma and 6 cases of gastric stromal tumors were collected. HE staining of paraffin blocks was performed. Immunohistochemical staining for Desmin, vim entin, SMA, S100, CD34 and CKp were performed. Results The clinical changes of gastric eosinophilic granuloma and gastric stromal tumors were similar and difficult to distinguish. The histological changes were different. Gastric eosinophilic granuloma spindle cells were unevenly distributed with a small amount of lymphocytes, scattered eosinophils, and Langerhans cells, while gastric stromal tumors consisted of uniformly distributed long spindle cells. Inflammatory cells. Immunohistochemically, gastric spindle cells were positive for vim entin in eosinophilic granuloma and positive for S100 in Langerhans cells. Gastric stromal tumor spindle cells were positive for CD34 and Vi imtin, and Desm in, SMA, S100, and CKp were negative. Conclusion The definitive diagnosis of gastric eosinophilic granuloma is based on histological changes and immunohistochemical staining. It is a benign lesion that cannot be cured by long duration and may be cancerous. Surgical treatment is effective.