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目的:分析食管恶性颗粒细胞瘤的临床特点及误诊为食管平滑肌瘤的原因,加强对此疾病的认识。方法:分析本院1例术前临床诊断为食管平滑肌瘤而术中探查发现和术后病理证实为食管恶性颗粒细胞瘤的诊疗经过。结果:术前检查包括上消化道造影、胸部CT以及超声内镜检查均支持食管平滑肌瘤,但术中未能完整切除,术后病理证实为食管恶性颗粒细胞瘤。结论:食管颗粒细胞瘤尤其恶性颗粒细胞瘤因为极其罕见,对该疾病发病机制、临床症状及良恶性鉴别方面的认识有所不足,术前常难以明确诊断,易误诊为食管平滑肌瘤,治疗原则也尚未形成统一的标准。因此,加强对此疾病的认识对于提高诊治水平、减少误诊及改善患者的预后有重要作用。
Objective: To analyze the clinical features of esophageal malignant granular cell tumor and the misdiagnosis of esophageal leiomyoma causes, to enhance awareness of the disease. Methods: One case of esophageal leiomyoma diagnosed preoperatively in our hospital was analyzed. The intraoperative findings and postoperative pathology confirmed the diagnosis and treatment of esophageal malignant granular cell tumor. Results: Preoperative examination including upper gastrointestinal angiography, chest CT and ultrasound endoscopy support esophageal leiomyoma, but failed to complete resection during operation, postoperative pathology confirmed as esophageal malignant granular cell tumor. Conclusion: esophageal granulosa cell tumor, especially malignant granulosa cell tumor, is extremely rare. The understanding of the pathogenesis, clinical symptoms and benign and malignant differentiation of esophageal granulosa cell tumor is not enough. It is difficult to diagnose esophageal leiomyoma easily and misdiagnosed as esophageal leiomyoma The principle has not yet formed a unified standard. Therefore, to enhance awareness of this disease to improve the diagnosis and treatment, reduce misdiagnosis and improve the prognosis of patients play an important role.