Higashi M, Takao S, Sato E
Second Department of Pathology, Faculty of Medicine, Kagoshima University, Kagoshima City, Japan.
Pathol Int. 1999 May;49(5):453-6. doi: 10.1046/j.1440-1827.1999.00877.x.
Sarcomatoid carcinoma of the pancreas is an uncommon neoplasm. The immunohistochemical characteristics of this unique type of pancreatic tumor were studied. Histologically, there was diffuse proliferation of atypical spindle cells that had hyperchromatic, short, spindle-shaped nuclei and pale cytoplasm. A few tiny foci of small tubular structures were seen in connection with the atypical spindle-shaped cells. Immunohistochemical examination showed that the spindle cells were positive for epithelial cell markers (cytokeratin AE3, cytokeratin AE1, epithelial membrane antigen) and DF3 (MUC1 apomucin-related antigen (ARA)), and were negative for markers such as vimentin, desmin, neuron-specific enolase, and myoglobin. DF3 antigen is known to be expressed in invasive ductal carcinoma of the pancreas and liver, as well as of the breast. Other MUC1-ARA (MY.1E12, MUC1 glycoprotein, HMFG-1, HMFG-2) and anti-CA19-9 were also detected in the present case. Thus, this tumor was diagnosed as anaplastic carcinoma (sarcomatoid carcinoma).
胰腺肉瘤样癌是一种罕见的肿瘤。对这种独特类型的胰腺肿瘤的免疫组化特征进行了研究。组织学上，非典型梭形细胞弥漫性增生，细胞核深染、短梭形，细胞质淡染。在非典型梭形细胞中可见一些微小的小管状结构灶。免疫组化检查显示，梭形细胞上皮细胞标志物（细胞角蛋白AE3、细胞角蛋白AE1、上皮膜抗原）和DF3（MUC1脱辅基粘蛋白相关抗原（ARA））呈阳性，波形蛋白、结蛋白、神经元特异性烯醇化酶和肌红蛋白等标志物呈阴性。已知DF3抗原在胰腺、肝脏以及乳腺的浸润性导管癌中表达。本病例中还检测到其他MUC1-ARA（MY.1E12、MUC1糖蛋白、HMFG-1、HMFG-2）和抗CA19-9。因此，该肿瘤被诊断为间变性癌（肉瘤样癌）。
