Katsube Otohiro, Saito Shin, Hosoya Yoshinori, Komatsubara Toshihide, Ui Takashi, Kurashina Kentaro, Haruta Hidenori, Zuiki Toru, Yamaguchi Takehiko, Sata Naohiro, Yasuda Yoshikazu
Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
Department of Pathology, Jichi Medical University, Tochigi, Japan.
Clin J Gastroenterol. 2013 Jun;6(3):207-10. doi: 10.1007/s12328-013-0377-y. Epub 2013 Mar 31.
We report on a 53-year-old male with esophageal cancer. He had no evidence of distant metastasis, and received a subtotal esophagectomy. Histopathologically, the tumors were contiguous with Barrett's epithelium. Undifferentiated carcinoma components existed independently of differentiated adenocarcinoma components. Undifferentiated carcinoma was present proximal to the esophagogastric junction. Both tumors had invaded the submucosa and were associated with a prominent lymphoid stroma. Metastasis from undifferentiated carcinoma was found in the paraesophageal lymph nodes. Immunohistochemically, both components were negative for 34bE12 and positive for CAM5.2 and showed nearly identical staining patterns for p53, indicating that the tumors were derived from Barrett's epithelium. Because the undifferentiated carcinoma did not express CK20 or carcinoembryonic antigen, the properties of adenocarcinoma had apparently been lost during the process of tumor cell progression. This is the first report of undifferentiated carcinoma associated with Barrett's esophagus with adenocarcinoma.
我们报告了一名53岁的食管癌男性患者。他没有远处转移的证据，并接受了食管次全切除术。组织病理学检查显示，肿瘤与巴雷特食管上皮相连。未分化癌成分独立于分化型腺癌成分存在。未分化癌位于食管胃交界处近端。两种肿瘤均侵犯了黏膜下层，并伴有显著的淋巴样间质。在食管旁淋巴结中发现了未分化癌转移。免疫组织化学检查显示，两种成分对34bE12均为阴性，对CAM5.2均为阳性，且p53染色模式几乎相同，表明肿瘤来源于巴雷特食管上皮。由于未分化癌不表达CK20或癌胚抗原，腺癌的特性在肿瘤细胞进展过程中显然已经丧失。这是首例与巴雷特食管腺癌相关的未分化癌报告。
