Noda M, Miwa A, Kitagawa M
Department of Pathology, Toyama Medical and Pharmaceutical University, Japan.
Am J Gastroenterol. 1989 Aug;84(8):953-7.
Two patients with gallbladder carcinoid tumors with adenocarcinomatous differentiation were examined. In both cases, the tumor contained argyrophilic granules and alcian blue-positive mucin. One contained argentaffin granules and the other showed PAS-positive mucin. Numerous membrane-bound electron-dense neurosecretory granules were demonstrated by ultrastructural study. Immunohistochemistry applied for the tumors clarified the epithelial, hormonal, and metaplastic character. Epithelial tumor markers, i.e., carcinoembryonic antigen (CEA) and epithelial membrane antigen (EMA), were positive in these tumors. The neuroendocrine nature was demonstrated by positive results of chromogranin A and neuron-specific enolase (NSE). Hormonal activities were not confirmed in the tumor cells. These results suggested that carcinoid tumors in the gallbladder have a multidirectional differentiation represented by a morphological continuum ranging from carcinoid to adenocarcinoma.
对两名具有腺癌分化的胆囊类癌肿瘤患者进行了检查。在这两个病例中，肿瘤均含有嗜银颗粒和阿利新蓝阳性黏液。其中一个含有亲银颗粒，另一个显示PAS阳性黏液。超微结构研究证实存在大量膜结合的电子致密神经分泌颗粒。对肿瘤进行的免疫组织化学检查明确了其上皮、激素和化生特征。上皮性肿瘤标志物，即癌胚抗原（CEA）和上皮膜抗原（EMA），在这些肿瘤中呈阳性。嗜铬粒蛋白A和神经元特异性烯醇化酶（NSE）的阳性结果证实了其神经内分泌性质。肿瘤细胞中未证实有激素活性。这些结果表明，胆囊类癌肿瘤具有多向分化，表现为从类癌到腺癌的形态学连续谱。
