Small bud of probable gastrointestinal stromal tumor within a laparoscopically-resected gastric schwannoma
Small bud of probable gastrointestinal stromal tumor within a laparoscopically-resected gastric schwannoma
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DOI：
10.1007/s10147-011-0296-1
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发表时间：
2012-06-01
影响因子：
3.3
通讯作者：
Miyagi, Yohei
中科院分区：
文献类型：
--
作者：
Cho, Haruhiko;Watanabe, Takafumi;Miyagi, Yohei
胃肠道粘膜下肿瘤（SMT）可能难以病理诊断。我们报告一例胃SMT是切除腹腔镜胃部分切除术。虽然最初的组织学和免疫组化检查认为肿瘤是神经鞘瘤，但基于mRNA的KIT基因分型表明肿瘤包括KIT基因表达的细胞，并且少数细胞携带外显子11的缺失突变。进一步的组织病理学研究显示，在S-100阳性神经鞘瘤细胞中散布着少量增大的梭形上皮样细胞聚集体，这些细胞对KIT、CD 34和DOG 1呈阳性，对S-100呈阴性。我们认为，携带KIT基因突变的细胞是胃肠道间质瘤（GIST）的显微芽，据我们所知，这是第一次报告可能GIST组织中确定的神经鞘瘤。我们的观察提高了基因分型的诊断胃肠道SMTs的意义。
Submucosal tumors (SMTs) of the gastrointestinal (GI) tract can be potentially difficulty to diagnose pathologically. We report a case of a gastric SMT that was resected by laparoscopic partial gastrectomy. Although the initial histological and immunohistochemical examinations considered the tumor as a schwannoma, mRNA-based KIT genotyping indicated that the tumor included cells with KIT gene expression, and that a small number of cells carried a deletion mutation in exon 11. Additional histopathological investigations revealed small aggregates of enlarged spindle to epithelioid cells, which were positive for KIT, CD34 and DOG1, and negative for S-100, scattered among the S-100-positive schwannoma cells. We consider that the cells carrying the KIT gene mutation are microscopic buds of a gastrointestinal stroma tumor (GIST), and to the best of our knowledge, this is the first report of probable GIST tissues identified in a schwannoma. Our observations raised the significance of genotyping for diagnosis of GI tract SMTs.