胆囊癌肉瘤伴神经内分泌分化1例报道及文献复习  

Carcinosarcoma of Gallbladder with Neuroendocrine Differentiation:A Case Report and Review of Literature

作　　者：王占成[1] 

机构地区：[1]焦作煤业集团中央医院病理科,河南焦作454000

出　　处：《河南肿瘤学杂志》2005年第3期209-210,共2页Henan Journal of Oncology

摘　　要：目的探讨胆囊癌肉瘤伴神经内分泌分化的临床病理学特征及诊断、鉴别诊断要点。方法对1例胆囊癌肉瘤伴神经内分泌分化进行临床病理分析及免疫组化研究。结果胆囊癌肉瘤伴神经内分泌分化临床上可以表现为腹部疼痛而体格检查阴性;镜下肿瘤组织由癌和肉瘤两种成分组成。癌细胞排列呈不规则腺样、点片状和巢状,部分区域呈实性。癌细胞有丰富的嗜酸性胞浆,异型明显,可见核分裂象。肉瘤成分梭形细胞丰富,排列呈束状,细胞异型明显,可见核分裂象。两种成分无移行现象。免疫组化:癌细胞CKL(+)、CGA(+)和Syn(+),Vimentin(-)。癌细胞神经内分泌标志阳性。肉瘤成份Vimentin(+),CKL(-)、CD117(-)和SMA(-)。结论胆囊癌肉瘤伴神经内分泌分化是一种罕见的恶性肿瘤,其诊断和鉴别诊断主要依靠病理组织学和免疫组化方法。Objective To explore the clinicopathologic features and differential diagnosis of carcinosarcoma of gallbladder with neuroendocrine differentiation.Methods A case of carcinosarcoma of gallbladder with neuroendocrine differentiation was studied with conventional histopathological and immunohistochemical stains.Results The clinical symptoms of carcinosarcoma of the gallbladder with neuroendocrine differentiation were abdominal pain and no other positive physical examination findings. Histopathology showed neoplasm composed of carcinoma and sarcoma. Between carcinoma and sarcoma it showed no transitional areas. The carcinomatous cells arranged in irregular adenoid,pieces, trabecular, nest and sheets.The cells had abundant eosinophilic cytoplasm, and they were huge in size, with bizarre nuclei and mitoses. The sarcomatous component contained abundant spindle cells proliferation, arranged in fascicles pattern. Many tumor cells were huge in size, with bizarre nuclei and abnormal mitoses. Immunohistochemical stain showed positive for CK L, CGA and Syn, negative for Vimentin of carcinomatous cells. And neuroendocrine markers were positive for carcinomatous cells. Sarcomatous components were positive for Vimentin, negative for CK L, CD117 and SMA.Conclusions Carcinosarcoma with neuroendocrine differentiation is a rare malignant neoplasm.The diagnosis and differential diagnosis of carcinosarcoma mainly relie on histopathological and immunohistochemical findings.

关 键 词：胆囊 癌肉瘤 临床病理学 

分 类 号：R735.8[医药卫生—肿瘤]