胃血管球瘤3例临床病理分析

目的 探讨胃血管球瘤的临床病理学特点、诊断、鉴别诊断及预后.方法 分析3例胃血管球瘤的临床特征、组织学及免疫组化表型并复习文献.结果 3例患者术前临床均考虑为胃肠间质瘤,术后病理诊断为胃血管球瘤.组织学主要表现为瘤组织富于薄壁血管,瘤细胞围绕在血管周围呈实性巢片状,血管外皮瘤样穿插于肌层组织间,瘤细胞大小较一致,圆形或类圆形,胞质红染或透亮.网状纤维染色瘤细胞间、细胞巢团周围及血管周围均见网状纤维围绕.免疫组化示瘤细胞SMA和vimentin(+).3例患者术后随访12～ 60个月均无复发和转移.结论 胃血管球瘤具有特定的组织学改变及免疫表型,是一种罕见的良性肿瘤,需与胃肠间质瘤等相鉴别.

Gastric glomus tumors:a clinicopathological analysis of three cases

Objective To investigate the clinicopathological features,diagnosis,differential diagnosis and prognosis of gastric glomus tumors.Methods The clinical features,histopathological changes and immunohistochemical findings were analyzed in three cases of gastric glomus tumors,with review of the related literature.Results The three cases were considered as gastrointestinal stromal tumors by clinician before operation and were diagnosed as glomus tumor by pathologic examination after operation.Histologically,the tumor was abundant of thin-walled vessels and tumor cells arranged around blood vessles showing a solid or hemangiopericytoma-like pattern,interspersed in the muscle tissues,and the tumor cells were round or oval,had eosinophilic or clear cytoplasm.Reticular fiber staining showed that reticular fibers was around cell,cell nests and vessels.Immunohistochemically,the tumor cells were mainly positive for SMA and vimentin.All three cases had no evidence of recurrence or metastasis in follow-up for 12-60 months.Conclusions Gastric glomus tumor was an extremelly rare and benign tumor with distinct histopathological and immunohistochemical findings and it should be distinguished from other tumors such as gastrointestinal stromal tumors.