Kusama H, Takizawa N
Division of Pathology, Tokyo Medical College, Ibaraki-Pref.
Rinsho Byori. 1992 Feb;40(2):210-4.
This paper is a report of a large cell carcinoma (solid carcinoma with mucus formation-WHO) which developed in the right upper lobe of a 71-year-old woman and in which cytoplasmic Mallory body-like inclusions (MBL) similar to Mallory bodies (MB) often found in alcoholic liver disease and hepatocellular carcinoma were noted in the tumor cells. MBL was an eosinophilic massive or reticular hyalin, and showed staining properties similar to those of MB in general stainings. Electron microscopically, it was made up mainly of a fine granular amorphous substance with high electron density and was not surrounded by a membrane. A part of the margin was in close contact with filaments approximately 10 nm in diameter, with tonofibril-like structures around it, which suggested a relationship with cytokeratin. On immunoperoxidase staining using a couple of cytokeratin antibodies, definitely positive findings were not obtained with MBL themselves. MBL of this case basically has the same character as that of MBL which appears in fibrous lesions in the lung and MB in liver disease. It was concluded that it is necessary to preoperatively distinguish this entity cytologically or histologically from pulmonary metastasis of hepatocellular carcinoma.
本文报告了一例发生于一名71岁女性右上叶的大细胞癌(世界卫生组织分类中的伴有黏液形成的实体癌),在该肿瘤细胞中发现了类似于酒精性肝病和肝细胞癌中常见的马洛里小体(MB)的细胞质马洛里小体样包涵体(MBL)。MBL为嗜酸性块状或网状透明质,在常规染色中显示出与MB相似的染色特性。电镜下,它主要由具有高电子密度的细颗粒无定形物质组成,且无膜包绕。其部分边缘与直径约10nm的细丝紧密接触,周围有张力原纤维样结构,提示与细胞角蛋白有关。使用几种细胞角蛋白抗体进行免疫过氧化物酶染色时,MBL本身未获得明确的阳性结果。该病例的MBL与出现在肺部纤维性病变中的MBL以及肝病中的MB基本具有相同特征。得出结论,术前有必要从细胞学或组织学上鉴别该实体与肝细胞癌肺转移。