Armaghani Avan, Hernandez Gonzalo David, Daily Karen
Department of Internal Medicine, University of Florida, Gainesville, Florida, USA.
Department of Pathology, University of Florida, Gainesville, Florida, USA.
BMJ Case Rep. 2015 Apr 16;2015:bcr2014206222. doi: 10.1136/bcr-2014-206222.
Hepatoid adenocarcinoma (HAC) is a rare extrahepatic adenocarcinoma that morphologically and immunophenotypically mimics hepatocellular carcinoma (HCC). We report the case of a 42-year-old woman with an extensive cancer history who presented with right-sided abdominal pain and lower gastrointestinal (GI) bleeding, and was ultimately diagnosed with colon adenocarcinoma. She underwent sigmoidectomy and adjuvant chemotherapy. Approximately 1 month after completion of chemotherapy, positron emission tomography showed presence of a 1.8 cm × 1.4 cm mesenteric lymph node. She underwent treatment with chemotherapy and radiation followed by lymph node resection. Pathological findings from the lymph node were consistent with poorly differentiated carcinoma with hepatocellular differentiation. When compared with pathology from the colonic resection, both specimens showed histomorphological features and immunohistochemical profiles consistent with hepatocellular differentiation. Given these findings, a diagnosis of HAC of the colon with metastasis to a mesenteric lymph node was made.
肝样腺癌（HAC）是一种罕见的肝外腺癌，在形态学和免疫表型上模仿肝细胞癌（HCC）。我们报告了一例42岁有广泛癌症病史的女性病例，该患者出现右侧腹痛和下消化道（GI）出血，最终被诊断为结肠腺癌。她接受了乙状结肠切除术和辅助化疗。化疗结束约1个月后，正电子发射断层扫描显示有一个1.8 cm×1.4 cm的肠系膜淋巴结。她接受了化疗和放疗，随后进行了淋巴结切除术。淋巴结的病理结果与具有肝细胞分化的低分化癌一致。与结肠切除标本的病理相比，两个标本均显示出与肝细胞分化一致的组织形态学特征和免疫组化谱。基于这些发现，作出了结肠HAC伴肠系膜淋巴结转移的诊断。
