Gaeta Raffaele, Ugolini Clara, Castagna Maura
U.O. Anatomia Patologica III, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Pisa, Italy.
Appl Immunohistochem Mol Morphol. 2016 Feb;24(2):e6-8. doi: 10.1097/PAI.0000000000000286.
Hepatoid adenocarcinoma (HAC) is a rare but important type of extrahepatic tumor that has a morphologic similarity to hepatocellular carcinoma, with production of α-fetoprotein in high amounts and a poor prognosis. Stomach is one of the organs in which HAC has been most commonly identified. We report a case of an old man with a polypoid mass in the prepyloric region. The microscopical aspects were suggestive for an undifferentiated adenocarcinoma, but the positive immunohistochemical staining for α-fetoprotein, α-1-antitrypsin, α-1-antichymotrypsin, and Hep Par1 were crucial for the final diagnosis of hepatoid adenocarcinoma of the stomach. Because of the poor prognosis for this type of tumor, correct and early-stage diagnosis of HAC is essential and long-term follow-up is required.
肝样腺癌(HAC)是一种罕见但重要的肝外肿瘤,其形态与肝细胞癌相似,可大量产生甲胎蛋白,预后较差。胃是最常发现HAC的器官之一。我们报告一例老年男性,其胃幽门前区有一息肉样肿物。显微镜下表现提示为未分化腺癌,但甲胎蛋白、α-1抗胰蛋白酶、α-1抗糜蛋白酶和Hep Par1免疫组化染色阳性对胃肝样腺癌的最终诊断至关重要。由于这类肿瘤预后较差,HAC的正确早期诊断至关重要,且需要长期随访。