Kuroda Naoto, Oonishi Kazuhisa, Ohara Masahiko, Hirouchi Takashi, Mizuno Keiko, Hayashi Yoshihiro, Lee Gang-Hong
Departments of Diagnostic Pathology, Kochi Red Cross Hospital, 2-13-51 Shin-honmachi, Kochi City, Kochi, Japan.
Med Mol Morphol. 2007 Dec;40(4):226-30. doi: 10.1007/s00795-007-0353-z. Epub 2007 Dec 21.
Invasive micropapillary carcinoma has recently been reported in various anatomic sites. In this article, we report a case of micropapillary carcinoma of the sigmoid colon. A 70-year-old Japanese woman presented with bloody stool for 2 months. Detailed examination disclosed ulcerative and localized tumor in the sigmoid colon. Histological examination of the colon tumor showed a combination of conventional adenocarcinoma (60%) and micropapillary carcinoma (40%). Immunohistochemically, micropapillary carcinoma cells were positive for cytokeratin (CK) 20, carcinoembryonic antigen, and CA125, but negative for CK7, thyroid transcription factor-1, surfactant apoprotein A, estrogen receptor, and progesterone receptor. Additionally, the immunohistochemistry of epithelial membrane antigen revealed reverse polarity of neoplastic cells. Results of conventional adenocarcinoma were basically identical to those of micropapillary carcinoma. In the stroma of both conventional adenocarcinoma and micropapillary carcinoma, many myofibroblasts were present and CD34-positive stromal cells were absent. Finally, we report the fourth case of micropapillary carcinoma arising in the colon. Immunohistochemical results of CK7(-)/CK20(+) strongly suggest the colon as a primary site of micropapillary carcinoma. Additionally, micropapillary carcinoma of the colon may cause a similar stromal reaction to conventional adenocarcinoma of the colon.
侵袭性微乳头癌最近在各种解剖部位均有报道。在本文中，我们报告了一例乙状结肠微乳头癌病例。一名70岁的日本女性出现便血2个月。详细检查发现乙状结肠有溃疡性局限性肿瘤。结肠肿瘤的组织学检查显示传统腺癌（60%）和微乳头癌（40%）并存。免疫组化显示，微乳头癌细胞细胞角蛋白（CK）20、癌胚抗原和CA125呈阳性，但CK7、甲状腺转录因子-1、表面活性蛋白A、雌激素受体和孕激素受体呈阴性。此外，上皮膜抗原的免疫组化显示肿瘤细胞极性反转。传统腺癌的结果与微乳头癌基本相同。在传统腺癌和微乳头癌的间质中，均存在许多肌成纤维细胞，且无CD34阳性间质细胞。最后，我们报告了第四例发生在结肠的微乳头癌。CK7（-）/CK20（+）的免疫组化结果强烈提示结肠是微乳头癌的原发部位。此外，结肠微乳头癌可能会引起与结肠传统腺癌相似的间质反应。
