Schwannoma of the gastrointestinal tract: a clinicopathological, immunohistochemical and ultrastructural study of 33 cases
Schwannoma of the gastrointestinal tract: a clinicopathological, immunohistochemical and ultrastructural study of 33 cases
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DOI：
10.1111/j.1365-2559.2006.02370.x
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发表时间：
2006-04-01
期刊：
影响因子：
6.4
通讯作者：
Zhu, XZ
中科院分区：
文献类型：
--
作者：
Hou, YY;Tan, YS;Zhu, XZ
目的：分析33例胃肠道神经鞘瘤的临床病理、免疫组织化学及超微结构特点。方法与结果：男性16例，女性17例，年龄27 ~ 81岁，中位52.6岁。肿瘤大小为直径10 ~ 120mm。23例患者随访6个月至13年无复发或转移。显微镜下，4例肿瘤均由梭形细胞和局灶上皮样细胞组成。除一例外，其余病例均有外周袖样淋巴样聚集体。免疫组化结果显示，S100蛋白和vimentin阳性，巢蛋白（78.8%,26/33）和胶质纤维酸性蛋白（63.6%,21/33）阳性，CD34阳性3例，CD117、α -平滑肌肌动蛋白和desmin均阴性。在超微结构上，肿瘤由细长的纺锤形细胞组成，具有明显的平行膜结构。结论：胃肠道神经鞘瘤具有不同于软组织和中枢神经系统神经鞘瘤的组织学特征，尤其是淋巴袖的存在。胃肠道神经鞘瘤表现为良性。
Aims: Thirty-three cases of gastrointestinal schwannomas were analysed to elucidate their peculiar clinicopathological, immunohistochemical and ultrastructural features.Methods and results: The patients were 16 men and 17 women, whose ages ranged from 27 to 81 years (median 52.6 years). Tumour size ranged from 10 to 120 mm in diameter. Follow-up in 23 cases from 6 months to 13 years showed no recurrences or metastases. Microscopically, all tumours were composed of spindle cells with focal epithelioid cells in four cases. In all cases except one, there were peripheral cuff-like lymphoid aggregates. Immunohistochemically, tumours were strongly positive for S100 protein and vimentin, the tumours were variably positive for nestin (78.8%, 26/33) and glial fibrillary acidic protein (63.6%, 21/33), three tumours had CD34+ cells, but all were negative for CD117, alpha-smooth muscle actin and desmin. Ultrastructurally, the tumours were composed of elongated spindle shaped cells with prominent parallel membranous structures.Conclusions: Gastrointestinal schwannomas have characteristic histological features, especially the presence of a lymphoid cuff, that are different from their soft tissue and central nervous system counterparts. Gastrointestinal tract schwannomas behave in a benign fashion.