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目的探讨胃胰腺异位(Ⅲ型)上皮癌变的临床病理特征和鉴别诊断。方法对1例胃胰腺异位(Ⅲ型)上皮癌变病例进行临床资料分析、病理形态观察和免疫组化检测,并结合文献进行讨论。结果该病临床表现无特征性,常有胃潴留。胃镜示黏膜粗大伴糜烂,幽门狭窄,十二指肠无异常。镜检:腺上皮和平滑肌异型增生,增生腺上皮形成腺管状、乳头状并有明显异型性,其周见平滑肌束穿插,可累及全层,胃小弯淋巴结,网膜组织见异型腺上皮转移或种植。免疫组化:CK7(+),CK20(-)。结论胃胰腺异位(Ⅲ型)是少见的良性病变,其上皮恶变更为罕见,应与皮革胃、先天性幽门肥大及胃肠道间质瘤等相鉴别。
Objective To investigate the clinicopathological features and differential diagnosis of ectopic (Ⅲ) epithelial carcinomas of the pancreas and pancreas. Methods One case of gastric cancer with ectopia (type Ⅲ) epithelial carcinogenesis was analyzed by clinical data, pathological observation and immunohistochemistry, and the literature was discussed. Results The clinical manifestations of the disease without characteristic, often gastric retention. Endoscopic mucosal thick with erosion, pyloric stenosis, no abnormal duodenum. Microscopic examination: glandular epithelium and smooth muscle dysplasia, glandular hyperplasia of the glandular epithelium formation, papillary and obvious atypia, the week see the smooth muscle bundle interspersed, can affect the full-thickness, small gastric lymph nodes, omental tissue showed abnormal glandular epithelial metastasis Or planting. Immunohistochemistry: CK7 (+), CK20 (-). Conclusion Gastric and pancreatic ectopic (type Ⅲ) is a rare benign disease. The epithelial malignant transformation is rare, and should be differentiated from leather stomach, congenital pyloric hypertrophy and gastrointestinal stromal tumors.