消化道平滑肌瘤35例临床病理学观察

目的 探讨消化道平滑肌瘤的病理学特点、免疫组化和鉴别诊断要点。方法 对35例消化道平滑肌瘤病例进行临床病理、组织化学与免疫组织化学观察。结果 35例平滑肌瘤中,食管18例、胃壁9例、空肠2例、回肠4例、结肠2例。临床表现为吞咽困难及梗阻、腹部包块、呕血及柏油样便。镜下见瘤细胞由分化成熟的平滑肌细胞组成,呈束状或编织状排列。Wasson染色瘤细胞呈红染,Van Gieson染色瘤细胞呈黄色。肌源性标记物Desmin,Actin,SMA见瘤细胞呈阳性反应。结论 消化道平滑肌瘤来源于胃肠道壁层平滑肌组织,确定诊断必须依靠病理,组化及免疫组化有助于鉴别诊断。

The Pathological Report of 35 Cases with Leiomyoma of Digestive Tract

Objective To study the chinicopathological characteristic, immunohisto chemical characteristic and mean opoint of differential diagnosis. Methods To observe 35 case with leiomyoma of digestive tract with clinicopathological method, histochemical and immunohistochemical methods. Results In 35 cases, 18 cases of esophagus,9 cases of gastric wall, 2 cases of colon, 4 ase of ileum, 2 cases of jejunum. These patients have following symptoms: dysphagia, abdominal mass, haematemesis and ta ry stools, with microscope,we could see that the tumor cell is made of differentiated smooth muscle cell,which is fasciculated or net arrangment, and the tumor cell is red with Masson color,yellow with Van Gieson color. The tumor cell is positive reaction when labeling with my-ogenic tag Desmin,Actin and SMA. Conclusion The leiomyoma of digestive tract is from smooth muscle tirsue of digestive tract wall, ifs diagnosis must be depended on pathology,and histochemical and immunohistochemical methods help to differential diagno-