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1病历摘要患者,男,61岁,因进食后恶心、呕吐伴进行性加重1个月,于2012年9月4日入我院胸外科。电子胃镜检查示食管下段邻近贲门、贲门、胃底、胃体小弯侧可见以溃疡型肿物,表面凹凸不平,周边呈堤样增生。病理诊断:(食管下段、贲门、胃底、胃体小弯)神经内分泌癌(小细胞型),核分裂象>20个/10 HPF。免疫组化染色结果:CK(+)、CD2(-)、CD3(-)、CD79a(-)、CD20(-)、MUM1(-)、CD10(+)、Bcl-6(+)、TTF-1(-)、CD56(+)、CgA(-)、Syn(+)。肝、胆、脾增强CT:肝脏多发转移瘤;胃小弯、腹主动脉旁、左侧肾上腺外支、脾门血管旁均可见转移性病变(图1A)。
1 medical record summary, male, 61 years old, due to nausea after eating, vomiting with progressive increase of 1 month, on September 4, 2012 into our hospital thoracic surgery. Electron gastroscopy showed proximal esophageal cardia, cardia, gastric fundus, small curvature of the side of the body can be seen with ulcerated tumor, the surface uneven, the surrounding dike-like hyperplasia. Pathological diagnosis: (lower esophagus, cardia, gastric fundus, gastric curvature) neuroendocrine carcinoma (small cell type), mitosis> 20/10 HPF. The results of immunohistochemistry showed that the expressions of CK (+), CD2 (-), CD3 (-), CD79a (-), CD20 (-), MUM1 (-), CD10 (+), Bcl- 1 (-), CD56 (+), CgA (-), Syn (+). Hepatic, gallbladder, splenomegaly CT: Multiple metastases in the liver; Metabolic lesions were seen in the lesser curvature of the stomach, adjacent to the abdominal aorta, the adductor of the left adrenal, and the splenic vasculature (Figure 1A).