Muraoka A, Suehiro I, Fujii M, Ueno H, Hayashi S, Shimizu K, Kitazawa R, Kitazawa S, Murakami K
Department of Internal Medicine, Suma Red Cross Hospital, Kobe, Japan.
J Gastroenterol. 1998 Jun;33(3):326-9. doi: 10.1007/s005350050091.
We report a type IIa early gastric cancer associated with xanthoma cell proliferation in a 61-year-old man. The patient was admitted to our hospital because of a gastric polyp detected at a medical checkup. An irregular protruding lesion with xanthoma cell proliferation was detected endoscopically. Histological examination showed a well differentiated tubular adenocarcinoma in the mucosa associated with xanthoma cell proliferation. The distribution of the xanthoma cells in the stroma corresponded closely with that of the cancer cells. Neither atypism nor mitotic figures were recognized in the xanthoma cells. In an immunohistochemical study, almost all the xanthoma cells were stained positive for alpha 1-antitrypsin, while relatively few exhibited positive S-100 protein staining. Specific monocyte chemotactic and activating factor immunoreactivity was present only in the xanthoma cells, and not in the cancer cells. On the basis of these findings, it was speculated that the gastric cancer cells may have caused the xanthoma cell proliferation via an autocrine mechanism i.e., by a chemical mediator acting in a paracrine or juxtacrine manner.
我们报告了一例61岁男性的IIa型早期胃癌，伴有黄色瘤细胞增殖。该患者因体检时发现胃息肉入院。内镜检查发现一个伴有黄色瘤细胞增殖的不规则突出病变。组织学检查显示黏膜内为高分化管状腺癌，伴有黄色瘤细胞增殖。间质中黄色瘤细胞的分布与癌细胞的分布密切对应。黄色瘤细胞中未发现异型性或有丝分裂象。在免疫组织化学研究中，几乎所有黄色瘤细胞α1-抗胰蛋白酶染色呈阳性，而仅有相对较少的细胞S-100蛋白染色呈阳性。特异性单核细胞趋化和激活因子免疫反应仅存在于黄色瘤细胞中，而不存在于癌细胞中。基于这些发现，推测胃癌细胞可能通过自分泌机制，即通过以旁分泌或邻分泌方式起作用的化学介质，导致了黄色瘤细胞增殖。
