Kuroda Naoto, Iwamura Shin-Ichi, Fujishima Nokiaki, Ohara Masahiko, Hirouchi Takashi, Mizuno Keiko, Hayashi Yoshihiro, Lee Gang-Hong
Department of Pathology, Kochi Red Cross Hospital, 2-13-51 Shin-honmachi, Kochi City, Kochi 780-8562, Japan.
Med Mol Morphol. 2007 Sep;40(3):168-71. doi: 10.1007/s00795-006-0349-0. Epub 2007 Sep 18.
A 59-year-old Japanese man presented with a giant submucosal tumor with ulceration during follow-up of duodenal ulcer. Pancreaticoduodenectomy was undertaken, and subsequent histological examination of the tumor disclosed anaplastic carcinoma of the pancreas head. The carcinoma components contained adenocarcinoma and squamous cell carcinoma. Additionally, undifferentiated spindle or pleomorphic cells were seen in continuity with the carcinoma component. Undifferentiated neoplastic cells with rhabdoid features and with hyaline globule-like structures positive for PAS stain with diastase pretreatment were also observed. Immunohistochemically, cytoplasmic inclusions corresponding to rhabdoid features showed aggregates of vimentin. Ultrastructurally, hyaline globule-like structures corresponded to lysosomes. Finally, we report here the first case of anaplastic carcinoma of the pancreas with hyaline globule-like structures.
一名59岁的日本男性在十二指肠溃疡随访期间出现了一个伴有溃疡的巨大黏膜下肿瘤。实施了胰十二指肠切除术,随后对肿瘤进行的组织学检查显示为胰头间变性癌。癌组织成分包括腺癌和鳞状细胞癌。此外,可见未分化的梭形或多形性细胞与癌组织成分相连。还观察到具有横纹肌样特征以及经淀粉酶预处理后对PAS染色呈阳性的透明小球样结构的未分化肿瘤细胞。免疫组织化学检查显示,对应于横纹肌样特征的细胞质包涵体表现为波形蛋白聚集。超微结构显示,透明小球样结构对应于溶酶体。最后,我们在此报告首例伴有透明小球样结构的胰腺间变性癌病例。