壁外性に細い茎部を有して発育していた胃gastrointestinal stromal tumorの1例  [in Japanese] A CASE OF GASTROINTESTINAL STROMAL TUMOR WITH A PEDUNCULATED AND EXTRAGASTRIC GROWTH  [in Japanese]

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Abstract

症例は50歳,男性.平成12年12月7日,胃透視で異常所見を指摘されたため上部消化管内視鏡検査を施行したところ,体下部大彎側前壁に胃粘膜下腫瘤を認めた.これに対しEUSを施行したところ胃壁外に径約35mmの内部エコー不均一な腫瘤を認めた.このため,診断的意味も含めて腹腔鏡下手術を施行したところ腫瘤は胃の漿膜面より細い茎部をもって発育するように存在し,周囲への浸潤も認めなかった.このため腫瘤を茎部で胃にわずかにかかるように切離しこれを摘出した.病理組織所見にて類円形から紡錘形の腫瘍細胞の増殖が認められ,また免疫染色にてdesmin, S-100蛋白陰性でCD34とc-kitが部分的に弱陽性であり,胃GISTと診断された.またこの腫瘍はその大きさや病理組織像からも良性腫瘍が疑われた.<br> われわれはこの珍しい形態を示した胃 GIST の1例を経験したので報告する.

A 50-year-old man was admitted to the hospital because of an abnormal shadow detected incidentally by a routine abdominal X-ray examination. Gastroduodenoscopies revealed a submucosal tumor at the greater curvature of the anterior lower body. EUS showed a heterogeneous tumor 35mm in diameter at the extragastric area. Laparoscopic surgery was performed for the treatment as well as diagnosis. Laparoscopic findings of the abdominal cavity revealed that the tumor had a small peduncle with a continuity to the stomach. The tumor did not invaded to other organs. Therefore a partial gastrectomy was performed. On histopathological examination, HE staining revealed that round-like or spindle cells grew in the tumor. In immunostaining, Desmin and S-100 protein were negative, and CD 34 and c-kit were mild positive. The tumor was diagnosed as gastrointestinal stromal tumor (GIST). It was suspected to be a benign tumor because of its size and histopathological findings. We report this case of GIST of unique morphorogy.

Journal

  • Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)

    Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 63(4), 890-894, 2002-04-25

    Japan Surgical Association

References:  12

Cited by:  5

Codes

  • NII Article ID (NAID)
    10008618860
  • NII NACSIS-CAT ID (NCID)
    AA11189709
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    13452843
  • Data Source
    CJP  CJPref  J-STAGE 
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