Fukuda T, Ohnishi Y
Second Department of Pathology, Niigata University School of Medicine, Japan.
Am J Gastroenterol. 1990 Oct;85(10):1403-6.
A primary carcinoma of the gallbladder producing human chorionic gonadotropin (HCG) was encountered in an 83-yr-old Japanese woman, with elevation of HCG/beta-HCG in urine and serum. Remarkable elevation of serum estradiol was an associated finding, with increased HCG. At autopsy, we found that the primary carcinoma of the gallbladder extensively involved the liver. Histologically, the tumor revealed adenosquamous cell carcinoma in the primary site, and moderately to poorly differentiated adenocarcinoma in metastatic foci. Immunohistochemical staining for beta-HCG showed a positive reaction in adenocarcinoma components. This is an extremely rare case of an HCG-producing gallbladder carcinoma, which leads us to speculate that HCG-positive tumor cells may occur due to dedifferentiation.
一名83岁的日本女性被诊断出患有产生人绒毛膜促性腺激素(HCG)的原发性胆囊癌,其尿液和血清中的HCG/β-HCG水平升高。血清雌二醇显著升高是与HCG升高相关的一个发现。尸检时,我们发现原发性胆囊癌广泛侵犯肝脏。组织学上,肿瘤在原发部位显示为腺鳞癌,转移灶为中分化至低分化腺癌。β-HCG免疫组化染色显示腺癌成分呈阳性反应。这是一例极其罕见的产生HCG的胆囊癌病例,这使我们推测HCG阳性肿瘤细胞可能是由于去分化而产生的。