消化系统粒细胞肉瘤临床病理分析

目的探讨消化系统粒细胞肉瘤的临床病理特点及诊断、鉴别诊断.方法对5例消化系统粒细胞肉瘤患者的病理组织进行HE及免疫组织化学染色观察,结合临床资料进行分析,并复习相关文献.结果 5位患者平均年龄38岁,受累部位为胃1例、小肠2例、胰头2例.临床主要表现为消化系统症状（上腹胀痛、腹胀、腹痛及黄疸）;胃、肠镜及影像学检查为消化器官占位.组织学表现为肿瘤细胞弥漫成片,瘤细胞幼稚、多样,肿瘤细胞间可见散在分布的幼稚嗜酸性粒细胞,原有组织结构常有多少不等的残存.免疫组化MPO（＋）,CD43（＋）,CD20（-）,CD3（-）,Ki-67约60%~80%.结论消化系统粒细胞肉瘤少见,误诊率高,免疫组织化学技术对于确诊本病具有重要价值.

Clinical and Pathological Analysis of Granulocytic Sarcoma in Digestive System

Objective To investigate the clinical pathological features, diagnosis and differential diagnosis of digestive system granulocytic sarcoma. Methods HE and immunohistochemistry staining（IHC） were used to observe five cases of sarcoma in digestive system,the clinical data and relevant literatures were reviewed. Results The average age of the five patients was 38 years old.The tumor occurred in stomach in 1 case,2 cases were involved in small intestine and 2 cases in pancreac. The main clinical manifestations were digestive system symptoms（Abdominal pain,bloating,bellyache and jaundice）;Gastroscopy,colonoscopy and imaging showed Digestive organs placeholder. Histology showed tumor cells diffuse into the film, the tumor cells were naive, diverse,between tumor cells there were some scattered immature eosinophils,there were residual original structures. IHC showed MPO（＋）,CD43（＋）,CD20（-）,CD3（-）,Ki-67 60%-80%.Conclusions Granulocytic sarcoma in digestive system is a rare tumor with high misdiagnosis rate.IHC has great value for diagnosis of the disease.