肝原发性破骨细胞样巨细胞瘤临床病理观察  

A case study and literature review of primary osteoclast-like giant-cell tumor of liver

作　　者：施晓庄[1] 王立娟[1] 宝荣[1] 王旭东[1] 闫晓初[2] 

机构地区：[1]重庆市第九人民医院病理科,重庆400700 [2]第三军医大学西南医院病理学研究所,重庆400042

出　　处：《诊断病理学杂志》2016年第2期120-123,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨肝原发性破骨细胞样巨细胞瘤(OGCT)的组织学来源、临床病理特征及生物学行为。方法对1例肝原发性OGCT的大体、组织学特征、免疫组化进行观察并复习相关文献。结果患者女性,41岁。右上腹痛1周。巨检:肿物大小8 cm×4.5 cm×3 cm,部分突出肝被膜;切面灰红色、质韧,部分出血、坏死及囊性变。镜检:肿物由大量的单核间质细胞及破骨细胞样巨细胞组成,出血、坏死较多。免疫组化:单核间质细胞及破骨细胞样巨细胞CD68和vimentin(+),而CK7、SMA、CK19、CK18、EMA、溶菌酶、Hep Par-1、AFP、CK20和CD34均(-),Ki-67增殖指数15%。结论肝原发性OGCT是一种非常罕见的肿瘤,其诊断和生物学行为应该结合临床病理特征、免疫组化及是否有转移等综合因素,首先要排除转移性肿瘤。Objective To investigate the histology source, clinicopathologic feature and biological behavior of primary osteoclast-like giant cell tumor （OGCT） of liver. Methods To observe general, histologic feature and immunohistochemistry of one case of primary hepatic osteoclast-like giant cell tumor of liver, and review relevant literature. Results A 41 - year old woman is hospitalized after presenting with right upper abdominal pain for one week. The checked tumor size is 8 cm × 4. 5 cm × 3 cm, partly liver capsule protruding, section gray and red, tough, some hemorrhage, necrosis and cystic degeneration. Tumor by microscopic examination is composed of a large number of mononuclear stromal cells and osteoclast-like giant cells, which mainly presents with hemorrhage and necrosis. Immunohistochemistry： Mononuclear stromal cells and osteoclast-like giant cells appear CD68 and Vimentin, but CK7, SMA, CK19, CK18, EMA, ｜ysozyme, HepPar-1, AFP, CK20 and CD34 are negative, Ki-67 proliferation index being about 15%. Conclusion Primary OGCT of liver is a very rare tumor. Its diagnosis and biological behavior should be combined with clinicopathologic feature, immunohistochemistry and whether there are comprehensive factors such as metastasis, which eliminates metastatic tumors in the first place.

关 键 词：破骨细胞样巨细胞瘤 临床病理特征 生物学行为 免疫组化 

分 类 号：R735.7[医药卫生—肿瘤]