Seitz Guido, Zimmermann Arthur, Friess Helmut, Büchler Markus W
Department of Visceral and Transplantation Surgery and the Institute of Pathology, University of Berne, Berne, Switzerland.
Hum Pathol. 2002 Jul;33(7):765-9. doi: 10.1053/hupa.2002.125380.
A large hepatic tumor was detected in the noncirrhotic liver of a 27-year-old female patient. The tumor was radiologically characterized by a peripheral mass encircling a central ovoid tumor, and was resected by an extended right hemihepatectomy. Histologic examination revealed that the peripheral and major component of the tumor represented a fibrolamellar hepatocellular carcinoma, whereas the central, well-demarcated tumor was a less well-differentiated adult-type hepatocellular carcinoma completely encircled by the former. Cells of the peripheral tumor mass abundantly expressed cytokeratin-7, typically present in the fibrolamellar variant, whereas no cytokeratin-7 immunoreactivity was found in the central tumor. To our knowledge, this is the first reported case of a not admixed but clearly separated evolution of these 2 histologic patterns within the same tumor, and suggests that the 2 types of hepatocellular carcinoma may share a common pathogenic pathway.
在一名27岁女性患者的非肝硬化肝脏中检测到一个巨大的肝肿瘤。该肿瘤在影像学上的特征是外周肿块环绕着中央卵形肿瘤，并通过扩大右半肝切除术进行了切除。组织学检查显示，肿瘤的外周和主要成分是纤维板层型肝细胞癌，而中央界限清楚的肿瘤是分化程度较低的成人型肝细胞癌，完全被前者环绕。外周肿瘤块的细胞大量表达细胞角蛋白-7，这在纤维板层型变体中通常存在，而在中央肿瘤中未发现细胞角蛋白-7免疫反应性。据我们所知，这是首次报道的同一肿瘤内这两种组织学模式并非混合而是明显分离演变的病例，并提示这两种类型的肝细胞癌可能共享一条共同的致病途径。
