Dekker A, Ten Kate F J, Terpstra O T
Department of Pathology, Erasmus University, Rotterdam, The Netherlands.
Dig Dis Sci. 1989 Jun;34(6):952-8. doi: 10.1007/BF01540285.
The case of a 61-year-old woman with a surgically resected solitary cholangiocarcinoma of the liver is reported, where many discrete multiple bile duct hamartoma (MBDH) were also seen. The latter is a congenital lesion of the liver that potentially may be confused with widespread metastatic disease. The relationship between cholangiocarcinoma and MBDH was studied histologically by the use of an immunoperoxidase technique for cytokeratin. MBDH was strongly positive for cytokeratin, while the neoplasm showed this to a lesser extent, but a clear continuity between the MBDH epithelial cells and those of the neoplasm was demonstrated by the use of this technic. The potential use for the various cytokeratins in the differentiation of primary from secondary liver tumors, is discussed. This differentiation is a significant problem to the pathologist. Although cholangiocarcinoma may, on occasion, be associated with various congenital lesions of the bile ducts, the association with MBDH is extremely rare, this being only the third reported case.
报告了一例61岁女性患者，其肝脏孤立性胆管癌经手术切除，同时还发现了许多散在的多发性胆管错构瘤（MBDH）。后者是肝脏的一种先天性病变，可能会与广泛的转移性疾病相混淆。通过使用细胞角蛋白免疫过氧化物酶技术对胆管癌和MBDH之间的关系进行了组织学研究。MBDH对细胞角蛋白呈强阳性，而肿瘤的阳性程度较低，但通过该技术证明了MBDH上皮细胞与肿瘤上皮细胞之间存在明显的连续性。讨论了各种细胞角蛋白在原发性和继发性肝肿瘤鉴别中的潜在用途。这种鉴别对病理学家来说是一个重要问题。虽然胆管癌有时可能与胆管的各种先天性病变有关，但与MBDH的关联极为罕见，这是第三例报告病例。
