Hirano Atsuyuki, Tsuchida Kenji, Nakamura Makoto, Adachi Kazunori, Inagaki Yusuke, Yamakawa Yoshihiro, Kawai Hiroki, Kimura Yoshihide, Seno Kyoji, Kosugi Isao, Katsumi Kohei
Department of Gastroenterology, Nagoya City West Medical Center.
Nihon Shokakibyo Gakkai Zasshi. 2011 Oct;108(10):1705-11.
Extraskeletal neoplasms with osteoclast-like giant cells are very rare. These tumors are most frequently reported in the breast and pancreas, and but rarely in other sites. We report a case of duodenal malignant tumor with osteoclast-like giant cells. The patient was a 76-year-old man who presented with vomiting. Computed tomography, magnetic resonance imaging, and gastrointestinal endoscopy revealed a giant tumor in the ascending part of duodenum. Biopsy specimens showed an undifferentiated malignant tumor with benign multinucleated giant cells. Immunohistochemical staining indicated that the tumor cells were reactive with vimentin, but not with epithelial markers or the other mesenchymal markers, and the multinucleated giant cells were reactive with CD68. Thus, we diagnosed a malignant tumor of the ascending part of duodenum with osteoclast-like giant cells. To the best of our knowledge, this is the first case of duodenal malignant tumor with osteoclast-like giant cells in Japan.
伴有破骨细胞样巨细胞的骨外肿瘤非常罕见。这些肿瘤最常报道于乳腺和胰腺,而在其他部位则很少见。我们报告一例伴有破骨细胞样巨细胞的十二指肠恶性肿瘤。患者为一名76岁男性,表现为呕吐。计算机断层扫描、磁共振成像和胃肠内镜检查显示十二指肠升部有一个巨大肿瘤。活检标本显示为伴有良性多核巨细胞的未分化恶性肿瘤。免疫组织化学染色表明肿瘤细胞对波形蛋白有反应,但对上皮标志物或其他间充质标志物无反应,且多核巨细胞对CD68有反应。因此,我们诊断为十二指肠升部伴有破骨细胞样巨细胞的恶性肿瘤。据我们所知,这是日本首例伴有破骨细胞样巨细胞的十二指肠恶性肿瘤。