CAJ | 학술논문

目的：介绍胃碰撞瘤的组织学特点和临床表现，以提高对本病的认识。方法分析1例胃腺癌与淋巴瘤伴胃肠道间质瘤碰撞瘤的临床表现，且进行组织学及免疫组织化学标记研究，并复习相关文献。结果患者主要表现为吞咽困难。在全胃切除标本中，同一肿瘤内可见中分化管状腺癌和弥漫性大B 细胞性淋巴瘤呈浸润性生长，两种成分界限清楚、彼此靠近、互相融合，胃肠道间质瘤孤立胃壁病灶，三者形成碰撞瘤。腺癌表达上皮性标记物，而淋巴瘤表达B 细胞抗体，胃肠道间质瘤CD34、CD117、DOG-1（+）。结论胃碰撞瘤十分罕见。胃腺癌与淋巴瘤伴胃肠道间质瘤的碰撞瘤，代表了3种独立成分彼此碰撞。临床需要提高认识，识别这类罕见肿瘤，并根据不同成分制定合适的治疗方案。
목적：개소위팽당류적조직학특점화림상표현，이제고대본병적인식。방법분석1례위선암여림파류반위장도간질류팽당류적림상표현，차진행조직학급면역조직화학표기연구，병복습상관문헌。결과환자주요표현위탄인곤난。재전위절제표본중，동일종류내가견중분화관상선암화미만성대B 세포성림파류정침윤성생장，량충성분계한청초、피차고근、호상융합，위장도간질류고립위벽병조，삼자형성팽당류。선암표체상피성표기물，이림파류표체B 세포항체，위장도간질류CD34、CD117、DOG-1（+）。결론위팽당류십분한견。위선암여림파류반위장도간질류적팽당류，대표료3충독립성분피차팽당。림상수요제고인식，식별저류한견종류，병근거불동성분제정합괄적치료방안。
Objective To introduce the histopathological and clinical features of collision tumor of the stomach,and to improve the understanding of this disease. Methods Clinical manifestations and histological and immunohistochemical findings of collision tumor of gastric adenocarcinoma, lymphoma and gastrointestinal stromal tumor(GIST)were analyzed and literature review was performed in 1 patient. Results The patient mainly showed dysphagia. In the total gastrectomy specimen, moderately differentiated tubular adenocarcinoma and diffuse large B-cell lymphoma were intermingled within the same tumor with an infiltrative growth pattern. The two elements were adjacent to one another with clear boundaries and integration. However, GIST was an isolated focus in the stomach wall. The three types of tumors formed the collision tumor. The adenocarcinoma expressed epithelial markers ,lymphoma showed anti-B-cell antibodies,and GIST expressed CD34,CD117 and DOG-1.Conclusion The gastric coll-ision tumor composed of adenocarcinoma, lymphoma and GIST is very rare and represents the collision of three separate components. In addition, clinical awareness should be improved to identify the collision tumor and appropriate treatment plan should be developed according different components.