Lee Sang Eok, Park Shin Young
Department of Surgery, Konyang University Hospital, Daejeon, Korea.
J Korean Surg Soc. 2012 Nov;83(5):321-4. doi: 10.4174/jkss.2012.83.5.321. Epub 2012 Oct 29.
Sarcomatoid carcinoma of the small intestine is an extremely rare malignant neoplasm that usually has a poor prognosis. We report a case of sarcomatoid carcinoma arising in the small intestine in a 62-year-old man who was hospitalized for abdominal pain. Computed tomography revealed wall thickening of the small intestine. The resected specimen showed a gray-whitish solid mass with hemorrhage and necrosis. Microscopically, the tumor was composed of pleomorphic spindle and discohesive polygonal cells with frequent mitosis. No carcinomatous component was recognized. Immunohistochemistry revealed coexpression of cytokeratin and vimentin by the tumor cells, whereas expressions of C-kit, CD34, HMB-45, smooth muscle actin, and desmin were negative. The diagnosis was sarcomatoid carcinoma of the small intestine.
小肠肉瘤样癌是一种极其罕见的恶性肿瘤,预后通常较差。我们报告一例62岁男性小肠发生的肉瘤样癌,该患者因腹痛住院。计算机断层扫描显示小肠壁增厚。切除标本显示为灰白色实性肿块,伴有出血和坏死。显微镜下,肿瘤由多形性梭形细胞和散在的多边形细胞组成,有频繁的有丝分裂。未发现癌性成分。免疫组织化学显示肿瘤细胞同时表达细胞角蛋白和波形蛋白,而C-kit、CD34、HMB-45、平滑肌肌动蛋白和结蛋白的表达均为阴性。诊断为小肠肉瘤样癌。