Isomura T, Kojiro M, Kawano Y, Nakamura S, Naito H, Yoshida K, Nakayama Y, Nakayama T, Kubo Y
Acta Pathol Jpn. 1980 Jan;30(1):137-43. doi: 10.1111/j.1440-1827.1980.tb01310.x.
A 49-year-old woman was admitted to the hospital with a palpable mass in the right hypochondrium. A laparotomy was performed under the clinical diagnosis of a solitary cyst of the liver. The cystic lesion of the liver was removed. Although the histological finding of the cyst wall showed a similarity to hepatocellular carcinoma of trabecular pattern, the tumor cells with uniform nuclei and little mitotic figure were positive for both argyrophil and argentaffin reaction. The pathological diagnosis was metastatic carcinoid tumor of the liver. There was no carcinoid syndrome nor the other clinical symptoms after the operation and various postoperative examination could not reveal a primary site of the carcinoid tumor. The cystic lesion of the liver recurred ten months after the first operation and a second laparotomy was performed to reveal the primary site in the ileum: three submucosal tumors, 0.8, 0.7, and 0.3 cm. in diameter, two of them, however, extended into the muscle wall or subserosa and conclusively, the small lesion of the ileum metastasized into the liver as a large pseudocystic lesion.
一名49岁女性因右季肋部可触及肿块入院。临床诊断为肝孤立性囊肿，遂行剖腹手术。切除了肝脏的囊性病变。虽然囊肿壁的组织学表现与小梁型肝细胞癌相似，但细胞核均匀且有丝分裂象少的肿瘤细胞嗜银和亲银反应均呈阳性。病理诊断为肝转移性类癌肿瘤。术后既无类癌综合征也无其他临床症状，各种术后检查均未发现类癌肿瘤的原发部位。首次手术后10个月，肝脏囊性病变复发，再次剖腹手术以查明回肠的原发部位：有3个黏膜下肿瘤，直径分别为0.8、0.7和0.3厘米，其中2个已延伸至肌层或浆膜下层，最终，回肠的小病变转移至肝脏形成一个大的假性囊性病变。
