Nakajima T, Kubosawa H, Kondo Y, Konno A, Iwama S
Department of Pathology, Chiba University School of Medicine, Japan.
Am J Clin Pathol. 1988 Sep;90(3):309-12. doi: 10.1093/ajcp/90.3.309.
An adult case of combined hepatocellular-cholangiocarcinoma with variable sarcomatous changes is presented. Histologically, the tumor was composed of hepatocellular carcinoma, cholangiocarcinoma, and sarcomatous portions, including spindle-shaped, pleomorphic, and osteoplastic varieties. There was a transitional cell form between the carcinoma and sarcomatous cells. These tumor elements showed both independent and concurrent metastases. Immunohistochemical examination for keratin revealed positive staining in the tumor cells except for osteoplastic immature cells, whereas vimentin had positive results only in some sarcomatous cells. On the basis of these findings, the possibility of sarcomatous transformation of combined hepatocellular-cholangiocarcinoma was discussed.
本文报告一例伴有多种肉瘤样改变的成人肝细胞-胆管细胞癌合并病例。组织学上，肿瘤由肝细胞癌、胆管细胞癌和肉瘤样成分组成，包括梭形、多形性和骨母细胞样类型。在癌和肉瘤样细胞之间存在过渡细胞形态。这些肿瘤成分表现出独立转移和同时转移。角蛋白免疫组化检查显示，除骨母细胞样未成熟细胞外，肿瘤细胞呈阳性染色，而波形蛋白仅在部分肉瘤样细胞中呈阳性结果。基于这些发现，对肝细胞-胆管细胞癌合并肉瘤样转化的可能性进行了讨论。
