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原发性和转移性经典型肝细胞-胆管细胞癌的组织学异质性:病例系列

Histological heterogeneity in primary and metastatic classic combined hepatocellular-cholangiocarcinoma: a case series.

作者信息

De Vito Claudio, Sarker Debashis, Ross Paul, Heaton Nigel, Quaglia Alberto

机构信息

King's College Hospital, Institute of Liver Studies, London, UK.

Division of Clinical Pathology, Service de Pathologie Clinique, Geneva University Hospital, 1211, Geneva, Switzerland.

出版信息

Virchows Arch. 2017 Nov;471(5):619-629. doi: 10.1007/s00428-017-2196-x. Epub 2017 Jul 13.

Abstract

Combined hepatocellular-cholangiocarcinoma (cHCC-CC) is a rare and aggressive primary liver cancer with both hepatocellular and cholangiocellular differentiation. Due to its bi-phenotypic component, cHCC-CC is a heterogeneous tumour and histopathological analysis of metastatic deposits is poorly characterized. In this retrospective study, we describe four patients in whom the histology from resected specimens of both primary and recurrent and/or metastatic tumour was available for comparison and immunohistochemical characterization. Our study shows that recurrent or metastatic deposits replicate the heterogeneity of the primary cHCC-CC, that even originally small foci of divergent differentiation can become predominant later on and that hepatocellular and cholangiocellular components can show different tropism in distant organs. In our experience, the behaviour of recurrent/metastatic cHCC-CC is unpredictable and histological examination is necessary to guide treatment options at present.

摘要

肝细胞-胆管细胞癌(cHCC-CC)是一种罕见且侵袭性强的原发性肝癌,具有肝细胞和胆管细胞分化特征。由于其双表型成分,cHCC-CC是一种异质性肿瘤,对转移灶的组织病理学分析特征不明显。在这项回顾性研究中,我们描述了4例患者,其原发性和复发性和/或转移性肿瘤切除标本的组织学可供比较和免疫组化特征分析。我们的研究表明,复发性或转移性病灶复制了原发性cHCC-CC的异质性,即使最初微小的分化差异灶后来也可能占主导地位,并且肝细胞和胆管细胞成分在远处器官可表现出不同的趋向性。根据我们的经验,复发性/转移性cHCC-CC的行为不可预测,目前需要组织学检查来指导治疗方案的选择。

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