Colonic Neurogenic Lesion: An Admixture of Mucosal Neurofibromatous Lesion and Submucosal Ganglioneuromatous Lesion With Transition
Colonic Neurogenic Lesion: An Admixture of Mucosal Neurofibromatous Lesion and Submucosal Ganglioneuromatous Lesion With Transition
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DOI：
10.1177/1066896920904158
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发表时间：
2020-02-06
影响因子：
1.2
通讯作者：
Morikawa, Teppei
中科院分区：
文献类型：
--
作者：
Hashimoto, Hirotsugu;Koda, Hirotomo;Morikawa, Teppei
良性神经肿瘤或肿瘤样病变很少在胃肠道中发现。在这篇文章中，我们提出的情况下，乙状结肠的神经病变，这是偶然发现在一个68岁的男子与腹腔镜低位前切除术治疗晚期直肠乙状结肠交界处癌。在切除的标本中，在乙状结肠中发现了粘膜下肿瘤样突出病变。组织学上，肿瘤由粘膜神经纤维瘤样病变和粘膜下神经节细胞瘤样病变组成，两者之间存在过渡。免疫组化分析显示，在过渡区神经束膜破裂，沿着雪旺细胞和支持细胞的增殖，延伸到粘膜深层。这种转变表明，粘膜和粘膜下病变包括一个单一的病变，神经纤维瘤或神经节细胞神经瘤的诊断将是不够的，在这种情况下。因为我们不能将其归类为一个确定的单一实体，我们诊断该肿块为一个无法分类的结肠神经源性病变。总之，我们报告的情况下，一个极其罕见的发生不可分类的结肠神经源性病变包括过渡粘膜神经纤维瘤和粘膜下神经节细胞瘤病变的混合物。
Benign neural tumors or tumor-like lesions are rarely detected in the gastrointestinal tract. In this article, we present the case of a neural lesion of the sigmoid colon, which was incidentally detected in a 68-year-old man treated with laparoscopic low anterior resection for an advanced carcinoma of the rectosigmoid junction. Within the resected specimen, a submucosal tumor-like protruding lesion was found in the sigmoid colon. Histologically, the growth was composed of mucosal neurofibromatous and submucosal ganglioneuromatous lesions, between which there was transition. Immunohistochemical analysis revealed a rupture of the perineurium in the area of transition, along with a proliferation of Schwann cells and supporting cells extending into the deep mucosa. This transition indicated that the mucosal and submucosal lesions comprised a single lesion, and that a diagnosis of neurofibroma or ganglioneuroma would be inadequate in this case. Because we could not classify it as an established single entity, we diagnosed the mass as an unclassifiable colonic neurogenic lesion. In summary, we report the case of an extremely rare occurrence of an unclassifiable colonic neurogenic lesion comprising an admixture of transitioning mucosal neurofibromatous and submucosal ganglioneuromatous lesions.