Sakamoto Kazuhiro, Monobe Yasumasa, Kouno Masato, Moriya Takuya, Sasano Hironobu
Department of Pathology, Tohoku University Hospital, Sendai, Japan.
Pathol Int. 2004 Jan;54(1):52-6. doi: 10.1111/j.1440-1827.2004.01578.x.
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.
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。