Wolf H K, Garcia J A, Bossen E H
Department of Pathology, Duke University Medical Center, Durham, North Carolina, USA.
Mod Pathol. 1992 Nov;5(6):665-8.
An intrahepatic biliary cystadenocarcinoma in a 56-yr-old white man was characterized by pronounced oncocytic differentiation. Grossly the tumor was a well-demarcated cyst filled with numerous branching papillary fronds. Most tumor cells had abundant granular, intensely eosinophilic cytoplasm on light microscopic examination and large numbers of densely packed mitochondria by electron microscopy. Mucin-secreting cells were also present. The patient returned 20 mo after resection of the primary tumor with recurrent tumor in the liver and widely disseminated disease throughout the abdominal cavity, and he died 5 mo later. Although less differentiated, the recurrent tumor again contained greatly increased numbers of mitochondria. The partial loss of oncocytic differentiation in the evolution of the present case and the benign nature of purely oncocytic tumors suggest that in the presence of mixed histologic features the potential for tumor progression is primarily determined by the lesser differentiated or nononcocytic component. To the best of our knowledge, oncocytic differentiation has not been previously described in biliary neoplasia.
一名56岁白人男性的肝内胆管囊腺癌具有明显的嗜酸性细胞分化特征。大体上，肿瘤是一个界限清楚的囊肿，充满了许多分支状乳头样小叶。大多数肿瘤细胞在光镜检查下具有丰富的颗粒状、强嗜酸性细胞质，电镜检查显示有大量密集排列的线粒体。也存在分泌黏液的细胞。该患者在原发性肿瘤切除术后20个月复发，肝脏出现复发性肿瘤，且疾病广泛播散至整个腹腔，5个月后死亡。尽管分化程度较低，但复发性肿瘤中线粒体数量再次大量增加。本例肿瘤演变过程中嗜酸性细胞分化的部分丧失以及纯嗜酸性细胞瘤的良性性质表明，在存在混合组织学特征的情况下，肿瘤进展的潜能主要由分化程度较低或非嗜酸性细胞成分决定。据我们所知，嗜酸性细胞分化此前尚未在胆管肿瘤中被描述过。
