Nishihara K, Nagai E, Tsuneyoshi M, Nagashima M
Second Department of Pathology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Arch Pathol Lab Med. 1994 Feb;118(2):177-81.
A small-cell carcinoma combined with adenocarcinoma of the gallbladder was detected in a 71-year-old Japanese woman. A nodular mass measuring 4.0 x 5.0 cm was located in the fundus of the gallbladder, in which a tiny depressed lesion measuring 2 mm in diameter was macroscopically and stereomicroscopically observed. Histologically, the depressed area revealed small-cell carcinoma that consisted of atypical cells with small, round to oval nuclei and scanty cytoplasm and was surrounded by ordinary well-differentiated adenocarcinoma. Immunohistochemically, the tumor cells in an adenocarcinomatous area were diffusely positive for carcinoembryonic antigen and showed an interspersed positivity to serotonin and gastrin, while the tumor cells in the small-cell carcinoma area were negative for both antigens. The nuclear DNA content of the tumor cells of both components was aneuploid; however, the first G0/G1 peak of the small-cell carcinoma was much smaller than that of the adenocarcinoma. These results indicated that the tumor revealed a divergence in functional differentiation, and this feature suggested an initial phase of composite small-cell carcinoma and adenocarcinoma in the gallbladder.
在一名71岁的日本女性中检测到胆囊小细胞癌合并腺癌。一个大小为4.0×5.0 cm的结节状肿块位于胆囊底部，在其中肉眼和体视显微镜下观察到一个直径为2 mm的微小凹陷性病变。组织学上，凹陷区域显示为小细胞癌，由具有小的圆形至椭圆形核和少量细胞质的非典型细胞组成，并被普通的高分化腺癌包围。免疫组织化学显示，腺癌区域的肿瘤细胞癌胚抗原弥漫性阳性，对血清素和胃泌素呈散在阳性，而小细胞癌区域的肿瘤细胞这两种抗原均为阴性。两种成分的肿瘤细胞核DNA含量均为非整倍体；然而，小细胞癌的第一个G0/G1峰远小于腺癌的。这些结果表明该肿瘤在功能分化上存在差异，这一特征提示胆囊复合性小细胞癌和腺癌的初始阶段。
