Ebihara T, Koyama S, Hirai S, Nakahara A, Tanaka N, Yamagata S, Muto H, Fukutomi H, Osuga T, Doi M
Gan No Rinsho. 1987 Apr;33(4):399-405.
We experienced an autopsy case of alpha-fetoprotein(AFP)-producing advanced gastric carcinoma with liver metastasis. Microscopically, the tumor was compose by medullary nests of poorly differentiated adenocarcinoma cells. The cells had an exclusively hepatoid pattern characterized by discrete masses, nests, and broad bands, consisting of large eosinophilic epithelial cells and separated by fibrous stroma. Immunohistochemical studies of hepatoid cells yielded a positive reaction for AFP, but negative for CEA. Electron microscopically, tumor cells possess a ductal lumina with abundant microvilli having a central core filaments, and secretory granules in cytoplasma. These findings suggest that the tumor cells differentiated into intestinal direction, irrespective of the appearance of their hepatoid features characterized by light microscopy.
我们遇到一例伴有肝转移的产生甲胎蛋白（AFP）的晚期胃癌尸检病例。显微镜下，肿瘤由低分化腺癌细胞的髓样巢组成。细胞具有独特的肝样形态，其特征为离散的团块、巢状结构和宽带状结构，由大的嗜酸性上皮细胞组成，并被纤维性间质分隔。对肝样细胞的免疫组织化学研究显示AFP呈阳性反应，但癌胚抗原（CEA）呈阴性。电子显微镜下，肿瘤细胞具有带有丰富微绒毛的导管腔，微绒毛具有中央核心细丝，且细胞质中有分泌颗粒。这些发现表明，肿瘤细胞向肠方向分化，而不论其在光学显微镜下呈现的肝样特征如何。
