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A Case of a Gastrointestinal Stromal Tumor with Skeinoid Fibers of the Sigmoid Colon

机译:一例乙状结肠结肠纤维样胃肠道间质瘤

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摘要

An 80-year-old man was diagnosed with rectal cancer and underwent Hartmann's procedure. Although no tumors were identified during the preoperative examination, gross examination of the resected specimen incidentally revealed a submucosal tumor that was 9 mm in diameter at the oral side and located in the proximal stump of the specimen from the sigmoid colon. We suspected a concurrent gastrointestinal stromal tumor (GIST) and performed a histopathological examination. An L-shaped nodular lesion measuring 9 × 6 mm was histologically composed of a patternless proliferation of spindle cells intermingled with eosinophilic globules. Cellular atypia, prominent mitotic figures and necrotic foci were not observed in the nodule. The spindle cells were positive for CD34, CD117 and vimentin, but negative for CD56, smooth muscle actin and S-100 protein. MIB-1 positivity was estimated to be as low as approximately 1–2%. Electron microscopy showed a bundle of wool-like fibers with a periodicity of approximately 40 nm. We therefore considered the lesion to be a low-risk GIST with skeinoid fibers in the large intestine. Although numerous previous reports have reported skeinoid fibers in the stomach and small intestines, there have been only 9 cases (including the present case) of skeinoid fibers in the large intestine.
机译:一名80岁的男子被诊断患有直肠癌,并接受了Hartmann手术。尽管在术前检查中未发现肿瘤,但对切除的标本进行的粗略检查偶然发现了一个黏膜下肿瘤,其在口腔侧直径为9 mm,位于乙状结肠标本的近端残端。我们怀疑并发胃肠道间质瘤(GIST)并进行了组织病理学检查。在组织学上,一个L形的结节性病变为9×6 mm,是由梭形细胞与嗜酸性小球混合而成的无模式增殖。在结节中未观察到细胞异型,明显的有丝分裂图和坏死灶。梭形细胞对CD34,CD117和波形蛋白呈阳性,但对CD56,平滑肌肌动蛋白和S-100蛋白呈阴性。 MIB-1阳性率估计低至约1-2%。电子显微镜显示出一束周期性为约40 nm的羊毛状纤维。因此,我们认为该病灶为大肠中含有类蛇突纤维的低危GIST。尽管先前的许多报道都报道了胃和小肠中的类胡萝卜素纤维,但大肠中仅有9例(包括本例)类胡萝卜素纤维。

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