Oikawa I, Hirata K, Katsuramaki T, Mukaiya M, Sasaki K, Satoh M
Department of Surgery 1, Sapporo Medical University, Japan.
Surg Today. 1998;28(11):1192-5. doi: 10.1007/s005950050312.
We report herein the first documented case of gastrin-releasing peptide-positive neuroendocrine (NE) carcinoma of the extrahepatic biliary tract. An invasive tumor measuring 2.5 x 1.5 cm was located in the confluence portion of the cystic duct in a 70-year-old Japanese man. Histologically, the tumor was found to be composed of small polygonal cells which formed a solid and trabecular structure, and the frequencies of both mitoses and small necrotic areas were dominant. The tumor cells were immunoreactive to the NE markers chromogranin-A and neuron-specific enolase, as well as to carcinoembryonic antigen and gastrin-releasing peptide. Although a few cases of gastrin-releasing peptide-positive small-cell lung carcinoma have been documented, there have been no reports of gastrin-releasing peptide-positive NE carcinoma occurring in the gastrointestinal tract. We consider our case not merely to be of pathological interest, but also to have clinical and therapeutic implications.
我们在此报告首例有文献记载的肝外胆管胃泌素释放肽阳性神经内分泌（NE）癌。一名70岁日本男性的胆囊管汇合部有一个大小为2.5×1.5 cm的浸润性肿瘤。组织学检查发现，肿瘤由形成实性和小梁状结构的小多边形细胞组成，有丝分裂和小坏死区域的发生率较高。肿瘤细胞对NE标志物嗜铬粒蛋白A和神经元特异性烯醇化酶呈免疫反应，对癌胚抗原和胃泌素释放肽也呈免疫反应。虽然已有几例胃泌素释放肽阳性的小细胞肺癌的文献记载，但尚无胃肠道发生胃泌素释放肽阳性NE癌的报道。我们认为我们的病例不仅具有病理学意义，而且具有临床和治疗意义。
