Ali Sadaf, Shah Parveen, Shah Umer Javed, Shah Azra, Zargar Showkat, Bashir Atthar, Dhar Sunil, Ali Muzzafar
Department of Surgical Gastroentrology, SK Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, Srinagar, India.
Case Rep Gastroenterol. 2008 Nov 8;2(3):384-9. doi: 10.1159/000161563.
A 60-year-old lady presented to us with a right upper abdominal mass. With a clinical diagnosis of liver tumor, she was evaluated with abdominal CT, MRI, nuclear scan, tumor markers, USG guided FNAC and other baseline investigations. On evaluation she had a massive right lobe tumor crossing the midline. In view of the ambiguous diagnosis she was subjected to laparotomy where the lesion was judged unresectable and a biopsy was taken. Histopathological examination showed the rare pathology of primary fibrosarcoma of the liver with features of homogeneous, spindle-shaped cells with abundant collagen fibers showing a classic herringbone pattern. Tissue samples were then sent to another referral cancer hospital for immunohistochemistry and immunoreactive vimentin was found in the tumor cells. Electron microscopically, the tumor cells were rich in rough endoplasmic reticulum without a basement membrane, and were surrounded by large amounts of collagen fibers. The fibroblastic character of the tumor cells was suggested by light and electron microscopy.
一位60岁女性因右上腹肿物前来就诊。临床诊断为肝肿瘤,对其进行了腹部CT、MRI、核扫描、肿瘤标志物、超声引导下细针穿刺活检(FNAC)及其他基线检查。评估发现她右叶有一个巨大肿瘤,已越过中线。鉴于诊断不明确,她接受了剖腹手术,术中判断该病变无法切除并进行了活检。组织病理学检查显示为罕见的原发性肝纤维肉瘤病理,其特征为细胞均匀、呈梭形,有丰富的胶原纤维,呈现典型的人字形图案。随后将组织样本送往另一家转诊癌症医院进行免疫组化检查,发现肿瘤细胞中有免疫反应性波形蛋白。电镜下,肿瘤细胞富含粗面内质网,无基底膜,周围有大量胶原纤维。光镜和电镜检查提示肿瘤细胞具有成纤维细胞特征。