Drachenberg C B, Papadimitriou J C, Rivero M A, Wood C
Department of Pathology, University of Maryland School of Medicine, Baltimore.
Mod Pathol. 1991 May;4(3):392-5.
We are reporting a case of a mesenchymal hamartoma of the liver (MHL), found incidentally in a 69-yr-old woman. By light microscopy, the tumor was composed of cellular undifferentiated mesenchymal tissue, with pronounced cystic degeneration, and staining strongly positively for vimentin and negatively for cytokeratin. The cysts contained mucoid material and were lined by modified mesenchymal cells, staining positively for vimentin and negatively for epithelial or endothelial markers. Bile ducts scattered within the tumor and on its periphery stained positively for cytokeratin. No alpha-fetoprotein (AFP) or alpha 1-antitrypsin was identified. Fine needle aspiration (FNA) cytology of the tumor revealed loose clusters of oval cells with benign-appearing nuclei within a mucoid background. As observed by electron microscopy, the tumor cells were oval to spindle shaped with interconnected cytoplasmic processes forming intercellular cystic spaces, appearing to be the precursors of the larger cysts seen by light microscopy. MHL was initially considered as a tumor restricted to childhood; however, a few cases in young adults have since been described. With this case, the possibility of MHL occurrence in advanced age is documented.
我们报告了一例肝脏间叶性错构瘤（MHL），该病例是在一名69岁女性中偶然发现的。通过光学显微镜观察，肿瘤由细胞未分化间叶组织组成，伴有明显的囊性变，波形蛋白染色呈强阳性，细胞角蛋白染色呈阴性。囊肿内含有黏液样物质，内衬为改良的间叶细胞，波形蛋白染色呈阳性，上皮或内皮标志物染色呈阴性。散在于肿瘤及其周边的胆管细胞角蛋白染色呈阳性。未检测到甲胎蛋白（AFP）或α1-抗胰蛋白酶。肿瘤的细针穿刺（FNA）细胞学检查显示，在黏液样背景中有散在的椭圆形细胞簇，细胞核呈良性外观。通过电子显微镜观察，肿瘤细胞呈椭圆形至梭形，有相互连接的细胞质突起，形成细胞间囊性间隙，似乎是光学显微镜下所见较大囊肿的前体。MHL最初被认为是一种仅限于儿童期的肿瘤；然而，此后也有一些年轻成人病例的报道。通过该病例，证明了MHL在高龄患者中发生的可能性。
