Garcia Monica T, Bejarano Pablo A, Yssa Maria, Buitrago Efren, Livingstone Alan
Department of Pathology, University of Miami, Miller School of Medicine--Jackson Memorial Hospital, 1611 NW 12th Avenue, Holtz Building, Room 2042 G, Miami, FL 33136, USA.
Virchows Arch. 2006 Sep;449(3):376-81. doi: 10.1007/s00428-006-0251-0. Epub 2006 Aug 1.
We describe a rare hepatic collision tumor composed of a hepatocellular carcinoma and a high-grade neuroendocrine carcinoma. The patient, a 50-year-old man, underwent a partial hepatectomy because of a 5.0-cm mass. The tumor had two distinctive patterns. The majority of the tumor was a high-grade neuroendocrine carcinoma with features of a small cell carcinoma that was positive for chromogranin, synaptophysin, and cytokeratin 19 and negative for hepatocellular antigen and alpha-fetoprotein (AFP). The second component was a moderately differentiated hepatocellular carcinoma that was positive for hepatocellular antigen and AFP and negative for neuroendocrine markers. The two tumors were separated by fibrous bands. In areas where they collided, there was no transition or intermingling of cells between the two components, thus, it is different from the combined type of tumors. After removal of the tumor, the patient had intrahepatic and mesenteric recurrences within a follow-up period of 16 months.
我们描述了一例罕见的肝脏碰撞瘤，其由肝细胞癌和高级别神经内分泌癌组成。患者为一名50岁男性，因一个5.0厘米的肿块接受了部分肝切除术。该肿瘤有两种不同的形态。肿瘤的大部分是高级别神经内分泌癌，具有小细胞癌的特征，嗜铬粒蛋白、突触素和细胞角蛋白19呈阳性，肝细胞抗原和甲胎蛋白（AFP）呈阴性。第二个成分是中度分化的肝细胞癌，肝细胞抗原和AFP呈阳性，神经内分泌标志物呈阴性。这两种肿瘤被纤维带分隔开。在它们碰撞的区域，两种成分之间没有细胞过渡或混合，因此，它不同于肿瘤的联合类型。切除肿瘤后，患者在16个月的随访期内出现了肝内和肠系膜复发。
