Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Clin Mol Hepatol. 2012 Jun;18(2):229-34. doi: 10.3350/cmh.2012.18.2.229. Epub 2012 Jun 26.
A 45-year-old male with alleged asymptomatic hepatic hemangioma of 4 years duration had right upper-quadrant pain and was referred to a tertiary hospital. Computed tomography and magnetic resonance imaging scans revealed a hypervascular mass of about 7 cm containing intratumoral multilobulated cysts. A preoperative liver biopsy was performed, but this failed to provide a definitive diagnosis. The patient underwent a partial hepatectomy of segments IV and VIII. The histologic findings revealed multifocal proliferation of flattened or cuboidal epithelioid cells and a highly vascular edematous stroma. Immunohistochemistry findings demonstrated that the epithelioid tumor cells were positive for cytokeratin (AE1/AE3), vimentin, calretinin, and cytokeratin 5/6, and were focally positive for CD10, and negative for WT1 and CD34, all of which support their mesothelial origin. Immunohistochemistry for a mesothelial marker should be performed for determining the presence of an adenomatoid tumor when benign epithelioid cells are seen.
一位 45 岁男性，自述无症状肝血管瘤病史 4 年，出现右上腹疼痛，转至一家三级医院。计算机断层扫描和磁共振成像扫描显示一个约 7 厘米大小的富血管性肿块，其内有肿瘤内多叶状囊肿。行术前肝活检，但未能明确诊断。患者行 IV 段和 VIII 段部分肝切除术。组织学检查发现扁平或立方状上皮样细胞的多灶性增殖和高度血管性水肿基质。免疫组织化学检查显示上皮样肿瘤细胞对细胞角蛋白（AE1/AE3）、波形蛋白、钙视网膜蛋白和细胞角蛋白 5/6 阳性，局灶性对 CD10 阳性，对 WT1 和 CD34 阴性，所有这些均支持其间皮起源。当良性上皮样细胞出现时，为确定是否存在腺瘤样肿瘤，应进行间皮标志物的免疫组化检查。
