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胆囊肝样腺癌:病例报告及文献复习

Hepatoid adenocarcinoma of the gallbladder: Case report and review of the literature.

作者信息

Sakamoto Kazuhiro, Monobe Yasumasa, Kouno Masato, Moriya Takuya, Sasano Hironobu

机构信息

Department of Pathology, Tohoku University Hospital, Sendai, Japan.

出版信息

Pathol Int. 2004 Jan;54(1):52-6. doi: 10.1111/j.1440-1827.2004.01578.x.

Abstract

A rare case of hepatoid adenocarcinoma (HAC) of the gallbladder occurred in a 72-year-old man who presented with abdominal pain and was admitted to hospital. Ultrasonography and computed tomography revealed a mass in the gallbladder, multiple nodules in the liver and enlargement of the lymph nodes. He was diagnosed as having a gallbladder carcinoma with multiple liver and lymph node metastases. Cholecystectomy and partial hepatectomy was performed. Histologically, most of the mass in the gallbladder was composed of cells with eosinophilic cyto-plasm arranged in a trabecular pattern, which resembled hepatocellular carcinoma, but there was a component of well-differentiated adenocarcinoma in the mucosa. Immunohistochemically these hepatoid tumor cells were positive for Hepatocyte (Hepatocyte Paraffin 1: Hep Par1), which is considered highly sensitive and highly specific for hepatocyte differentiation. Based on these findings, this case was diagnosed as hepatoid adenocarcinoma of the gallbladder, which is generally a vary rare neoplasm in the literature, but should be included in the differential diagnosis of a mass in the gallbladder.

摘要

一名72岁男性因腹痛入院,被诊断为罕见的胆囊肝样腺癌(HAC)。超声检查和计算机断层扫描显示胆囊有肿块,肝脏有多个结节,淋巴结肿大。他被诊断为胆囊癌伴多发肝和淋巴结转移。行胆囊切除术和部分肝切除术。组织学上,胆囊内的大部分肿块由嗜酸性细胞质的细胞组成,呈小梁状排列,类似肝细胞癌,但黏膜中有高分化腺癌成分。免疫组化显示这些肝样肿瘤细胞对肝细胞(肝细胞石蜡1:Hep Par1)呈阳性,这被认为对肝细胞分化具有高度敏感性和高度特异性。基于这些发现,该病例被诊断为胆囊肝样腺癌,这在文献中通常是一种非常罕见的肿瘤,但在胆囊肿块的鉴别诊断中应予以考虑。

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