Kanamoto Mami, Yoshizumi Tomoharu, Ikegami Toru, Imura Satoru, Morine Yuji, Ikemoto Tetsuya, Sano Nobuya, Shimada Mitsuo
Department of Digestive and Pediatric Surgery, Institute of Health Biosciences The University of Tokushima Graduate School, Tokushima, Japan.
J Med Invest. 2008 Feb;55(1-2):161-5. doi: 10.2152/jmi.55.161.
Cholangiolocellular carcinoma (CLC) is an extremely rare malignant liver tumor which was first defined by Steiner, et al. in 1957 (1). CLC is thought to be derived from Hering's canal because tumor glands of CLC are morphologically similar to cholangioles. Recently, Theise, et al. reported that Hering's canal might be composed of hepatic stem cells (3). In addition, CLC sometimes contains a hepatocellular carcinoma (HCC) or cholangiocellular carcinoma (CCC) component within the tumor. Those findings suggest that CLC might originate from hepatic stem cells. On the other hand, because of its low frequency, clinicopatholigical features of CLC have not been fully clarified yet. We herein report a case of a 71-year old man with CLC. Based on preoperative imagings, the hepatic tumor was diagnosed as HCC, and he underwent a partial hepatectomy. The tumor contained both a HCC and CCC-like area. In immunohistochemistry, cytokeratin (CK) 7, CK20, CAM5.2 was positive, and CK19 was negative, therefore the tumor was diagnosed as CLC. The diagnostic criteria have not been described clearly, so CLC is difficult to diagnose preoperatively. Further studies are needed to clarify the clinical and clinicopatholigical features of CLC.
胆管细胞性肝癌（CLC）是一种极为罕见的肝脏恶性肿瘤，于1957年由施泰纳等人首次定义（1）。CLC被认为起源于赫林管，因为CLC的肿瘤腺管在形态上与胆小管相似。最近，泰斯等人报道赫林管可能由肝干细胞组成（3）。此外，CLC有时在肿瘤内含有肝细胞癌（HCC）或胆管细胞癌（CCC）成分。这些发现表明CLC可能起源于肝干细胞。另一方面，由于其发病率低，CLC的临床病理特征尚未完全阐明。我们在此报告一例71岁男性CLC患者。根据术前影像学检查，肝脏肿瘤被诊断为HCC，患者接受了部分肝切除术。肿瘤包含HCC和CCC样区域。免疫组织化学检查显示，细胞角蛋白（CK）7、CK20、CAM5.2呈阳性，CK19呈阴性，因此该肿瘤被诊断为CLC。诊断标准尚未明确描述，因此CLC术前难以诊断。需要进一步研究以阐明CLC的临床和临床病理特征。
