CAJ | 학술논문

目的：探讨胃肠道炎性纤维性息肉（ IFP）的临床病理特征、免疫表型、诊断及鉴别诊断。方法回顾性复习6例胃肠道IFP的临床资料、病理形态学特征及免疫表型特点，并结合相关文献复习。结果女性5例，男性1例；年龄44～87岁，中位年龄61岁，平均年龄62岁。2例发生在胃，2例发生在空肠，1例在回肠末端，1例在直肠；主要症状为腹部疼痛不适和排黑便。6例IFP镜下形态相似，主要位于黏膜下层，由形态温和的梭形细胞构成，混合大小不等增生的血管及多少不等的胶原纤维间质，部分扩张的血管周围间质水肿，部分血管周梭形细胞同心圆状排列形成旋涡状或“洋葱皮”样结构，并可见炎性细胞浸润，特征性的出现嗜酸性粒细胞的浸润。3例行手术切除，3例行内镜下肿物摘除。5例获得随访，均未见复发及转移。结论 IFP是胃肠道一种罕见的良性肿瘤，依靠病理学确诊，极易被误诊为胃肠道间质瘤或炎性肌纤维母细胞瘤。
목적：탐토위장도염성섬유성식육（ IFP）적림상병리특정、면역표형、진단급감별진단。방법회고성복습6례위장도IFP적림상자료、병리형태학특정급면역표형특점，병결합상관문헌복습。결과녀성5례，남성1례；년령44～87세，중위년령61세，평균년령62세。2례발생재위，2례발생재공장，1례재회장말단，1례재직장；주요증상위복부동통불괄화배흑편。6례IFP경하형태상사，주요위우점막하층，유형태온화적사형세포구성，혼합대소불등증생적혈관급다소불등적효원섬유간질，부분확장적혈관주위간질수종，부분혈관주사형세포동심원상배렬형성선와상혹“양총피”양결구，병가견염성세포침윤，특정성적출현기산성립세포적침윤。3례행수술절제，3례행내경하종물적제。5례획득수방，균미견복발급전이。결론 IFP시위장도일충한견적량성종류，의고병이학학진，겁역피오진위위장도간질류혹염성기섬유모세포류。
Objective To study the clinicopathologic characteristics , immunophenotypes , pathologic diagnosis and differential diagnosis of gastrointestinal inflammatory fibroid polyp ( IFP) .Methods The clinical data, histologic features and immunohistochemical results of 6 cases of gastrointestinal inflammatory fibroid polyp were analyzed , with review of literature.Results There were altogether 5 women and a man.The age of patients ranged from 44 to 87 years ( median age =61 years and mean age =62 years).The sites of involvement included stomach (number=2), jejunum (number=2), distal ileum ( number=1 ) and rectum ( number =1 ) .The patients often presented with abdominal pain or discomfort and tarry stool.All the cases studied showed similar morphology , were submucosa-based and composed of bland spindle cells associated with loose collagenous stroma and perivascular edema .Prominent concentric fibroblastic proliferation (“onion-skin” appearance ) and eosinophilic infiltrate were characteristics .Three of the patients underwent surgical resection .The remaining patients had the lesions removed with endoscopy . Follow-up data were available in 5 patients and none of them had disease recurrence or metastasis . Conclusions IFP is a rare benign tumor of gastrointestinal tract .Correct diagnosis primarily relies on pathologic examination .It needs to be distinguished from gastrointestinal stromal tumors or inflammatory myofibroblastic tumor .