脾转移性肝细胞癌1例  

Splenic metastatic hepatocellular carcinoma:A case report

作　　者：宋金灿 成元华 SONG Jincan;CHENG Yuanhua(Department of Pathology,College of Clinical Medicine,Guizhou Medical University,Guiyang 550004;Department of Pathology,Affiliated Hospital of Guizhou Medical University,Guiyang 550004,China)

机构地区：[1]贵州医科大学临床医学院病理学教研室,贵阳550004 [2]贵州医科大学附属医院病理科,贵阳550004

出　　处：《临床与病理杂志》2024年第11期1608-1612,共5页Journal of Clinical and Pathological Research

摘　　要：为探讨脾转移性肝细胞癌的临床病理特征和诊断要点,报告1例57岁老年男性脾转移性肝细胞癌的临床病理资料,观察其组织学形态及免疫表型特征,并复习相关文献。患者1年前体检发现脾占位性病变,于2023年5月22日行“脾脏切除术”后送检。镜下见肿瘤细胞大部分区域呈实性排列,小部分区域呈梁状排列;肿瘤细胞呈上皮样、多边形,细胞界限清楚,胞质呈嗜酸性细颗粒状,核异型性明显,核质比增高,可见瘤巨细胞,病理性核分裂象易见。部分肿瘤细胞围绕薄壁血窦样腔隙排列,形成器官样结构,可见坏死。结合患者肝细胞癌病史、组织形态学及免疫组织化学结果,诊断为脾转移性肝细胞癌。脾转移性肝细胞癌较为罕见,对其临床病理特征的分析可提高对形态相似肿瘤的认识。To investigate the clinicopathological characteristics and diagnostic features of splenic metastatic hepatocellular carcinoma,we report a case of splenic metastasis of hepatocellular carcinoma in a 57-year-old male patient.The histological morphology and immunophenotypic features were observed,and relevant literature was reviewed.The patient was found to have a splenic mass during a routine health examination 1 year prior and underwent splenectomy on 22 May,2023,with the specimen sent for pathological examination.Microscopically,the tumor cells exhibited a predominantly solid growth pattern,with focal areas showing a trabecular arrangement.The tumor cells were epithelial-like,polygonal in shape,with well-defined cell borders,eosinophilic finely granular cytoplasm,significant nuclear atypia,an increased nuclear-to-cytoplasmic ratio,and frequent pathological mitoses.Some tumor cells were arranged around thin-walled sinusoidal-like spaces,forming organoid structures,with areas of necrosis observed.Based on the patient’s history of hepatocellular carcinoma,histomorphology,and immunohistochemical findings,a diagnosis of splenic metastatic hepatocellular carcinoma was confirmed.Splenic metastasis of hepatocellular carcinoma is rare,and analyzing its clinicopathologic characteristics can enhance the recognition of morphologically similar tumors.

关 键 词：脾转移 肝细胞癌 脾肿瘤 病理学 免疫组织化学 

分 类 号：R735.7[医药卫生—肿瘤]