Kuroda N, Oonishi K, Iwamura S, Ohara M, Hirouchi T, Mizumo K, Miyazaki E, Enzan H
Department of Pathology and Laboratory Medicine, Kochi Red Cross Hospital, Kochi, Japan.
APMIS. 2006 Mar;114(3):234-8. doi: 10.1111/j.1600-0463.2006.apm_328.x.
Gastric carcinosarcoma with neuroendocrine differentiation is a very rare neoplasm. In this article we present such a case. The gastroendoscopic examination of a 59-year-old Japanese man disclosed gastric cancer during follow-up after operation for rectal cancer. Subsequently, total gastrectomy was carried out because of gastric cancer. A large tumor measuring 9.2 x 8.4 cm was observed in the posterior wall of the upper portion of the stomach. The tumor was composed of carcinoma and sarcomatous cells, and the histological transition of both components was observed. Immunohistochemically, carcinoma and sarcomatous cells were positive for cytokeratin CAM5.2. The carcinoma contained adenocarcinoma and malignant cells with neuroendocrine differentiation. The sarcomatous component showed leiomyosarcomatous and myofibroblastic differentiation. The present tumor is the fifth case of gastric carcinosarcoma with neuroendocrine differentiation and the first case of gastric carcinosarcoma with myofibroblastic differentiation. Pathologists should bear in mind that gastric carcinosarcoma may show various types of differentiation.
具有神经内分泌分化的胃癌肉瘤是一种非常罕见的肿瘤。在本文中，我们报告了这样一例病例。一名59岁日本男性在直肠癌手术后的随访中，经胃镜检查发现患有胃癌。随后，因胃癌进行了全胃切除术。在胃上部后壁观察到一个大小为9.2×8.4 cm的大肿瘤。肿瘤由癌和肉瘤样细胞组成，且观察到两种成分的组织学转变。免疫组织化学检查显示，癌和肉瘤样细胞对细胞角蛋白CAM5.2呈阳性。癌包含腺癌和具有神经内分泌分化的恶性细胞。肉瘤样成分显示为平滑肌肉瘤样和肌纤维母细胞样分化。本病例是具有神经内分泌分化的胃癌肉瘤的第5例，也是具有肌纤维母细胞样分化的胃癌肉瘤的首例。病理学家应牢记，胃癌肉瘤可能表现出多种类型的分化。
