胃肝样腺癌1例报道并文献复习

目的探讨胃肝样腺癌(hepatoid adenocarcinoma of thestomach)的临床与病理学特征。方法对1例少见的胃肝样腺癌进行光镜下组织学观察,同时进行免疫组化标记AFP、Glypican-3及Ki-67,并复习相关文献。结果患者男性,72岁,消化道钡餐显示胃底占位,胃镜活检病理示腺癌。镜下主要由腺癌区和肝样分化区域组成,两者相互移形过渡,腺癌区主要表现为管状腺癌,特征区域为肝样分化区,呈典型肝细胞癌样表现。癌细胞大,多边形,胞质丰富,呈嗜酸性或透明染色。瘤细胞排列方式类似肝癌组织,部分区域血窦丰富。免疫组化染色:肝样分化区域AFP部分(+),Glyp-cian-3部分弱(+),Ki-67增殖指数20%～30%。结论胃肝样腺癌是一种少见的胃癌组织学类型,具有肝样结构并产生AFP,根据组织学特征及免疫组化染色可做出明确诊断。     

食管胃双原发癌三例

食管和胃同时原发癌少见,术前诊断较困难,我院在过去对食管、胃肿瘤诊断中曾遇到三例,现报告如下。 一、临床资料:例一,患者男,76岁。进食梗阻感两     

胸腔积液诊断肾癌术后双原发癌1例

患者女性,62岁.因左侧肾癌术后伴双肺、全身淋巴结转移2年余,2周期免疫治疗后入院.2017年患者因左侧腰部疼痛检查示左肾肿物,行左肾切除,术后病理诊断:(左)肾嫌色细胞癌.术后3个月余CT复查示双肺多发结节、全身多发淋巴结肿大,考虑转移.1年前行颈部淋巴结穿刺活检示少许异型细胞,符合肾癌来源.2个月前患者出现反复刺激...     

胃肝样腺癌伴神经内分泌癌1例

患者男性,42岁。因上腹部不适伴黑便2月于2005年10月入院。胃镜提示贲门癌,CT示贲门癌伴肝转移,B超示肝内多发占位灶。实验室检查：血清NSE23．4μg／L（正常值0～15μg／L）。临床诊断：胃贲门癌伴肝转移,行全胃根治切除术和肝穿刺活检。     

乳腺癌肉瘤1例报道及文献复习

目的探讨乳腺癌肉瘤的临床病理学特征及其鉴别诊断。方法对1例乳腺癌肉瘤进行组织病理学和免疫表型观察并复习文献,了解该肿瘤的特征。结果镜检显示病变边界清楚,以软骨肉瘤为主,其边缘有少量分化较差的浸润性导管癌成分。免疫表型：软骨肉瘤细胞vimentin强阳性,S-100蛋白阳性,ER、PR,c-erbB-2和CK（AE1／AE3）均阴性;癌细胞CK（AE1／AE3）、ER、PR及c—erbB—2均阳性,vimenfin、S—100蛋白阴性。结论原发于乳腺的癌肉瘤较罕见,诊断需与乳腺恶性分叶状肿瘤以及软组织肉瘤鉴别。     

胃淋巴上皮瘤样癌1例并文献复习

目的 探讨胃淋巴上皮瘤样癌的临床病理学特点,诊断和鉴别诊断.方法 通过HE、免疫组化染色等方法对1例胃淋巴上皮瘤样癌进行分析,并复习文献.结果 瘤组织主要由弥漫浸润的瘤细胞和密集的淋巴细胞构成,常见淋巴滤泡形成,瘤细胞为大的卵圆形或多角形细胞,核空泡状,核仁明显,胞质丰富,呈嗜酸性.免疫表型:癌细胞CKpan(+)、EMA(+)、EB(-).结论 胃淋巴上皮瘤样癌是一种罕见的胃上皮来源恶性肿瘤,其诊断主要依靠组织病理学和免疫组化标记.     

卵巢有梭形细胞成分内膜样癌伴肝样癌1例报道及文献复习

目的：研究卵巢有梭形细胞成分宫内膜样癌伴肝样癌的临床病理特征以及肝样癌的组织发生。方法：收集和分析病人的临床病理资料。石蜡切片免疫组化ＡＢＣ法染色。结果：①１例６２岁老妇，患有原发性高度恶性卵巢癌，并伴有ＡＦＰ明显升高。ＡＦＰ常随病情变化而变化；②病理特征主要为有梭形细胞成分宫内膜样癌和明显肝样癌成分。免疫组化染色显示肝样癌及其癌细胞内外玻璃小体ＡＦＰ阳性；内膜样癌中腺上皮Ｋｅｒａｔｉｎ、ＥＭＡ、ＥＲ阳性；而梭形细胞则Ｋｅｒａｔｉｎ、ＥＭＡ和Ｖｉｍ阳性。而Ｄｅｓｍｉｎ、Ｍｙｏｇｌｏｂｉｎ、ＧＡＦＰ、ＨＣＧ所有瘤细胞均为阴性；③由于ＡＦＰ具有免疫抑制作用，患者预后不良。结论：以上结果表明，有梭形细胞成分卵巢宫内膜样癌伴肝样癌为卵巢一种特殊临床病理实体，反复复发后已完全向肝样癌转化     

睾丸原发性类癌1例报道及文献复习

1材料与方法患者,34岁,偶感右侧阴囊部坠胀不适6天,自查发现右侧睾丸明显较左侧睾丸大,而且较左侧硬。B超示右侧睾丸实质性占位性肿块;CT示右侧睾丸增大,实质性占位,考虑为肿瘤。体检:右侧阴囊皮肤无红肿,右侧睾丸大小5cm×3.8cm,质地较硬,无压痛;肛门、前列腺未见异常,腹股沟淋巴结及全身体表淋巴结未触及肿大。临床诊断:右侧睾丸肿瘤,行右侧睾丸切除术。术中见右侧睾丸内肿块3.1cm×2.8cm,质地较硬。标本经常规石蜡切片,HE染色,并做PCK、NSE、CgA、Syn、PLAP、vimentin和AFP免疫组化(S P法)标记。2病理检查2.1眼观右侧肿大的睾…     

甲状腺样肝内胆管细胞癌1例并文献复习

目的探讨甲状腺样肝内胆管细胞癌(thyroid-like intrahepatic cholangiocarcinoma, TLICC)的临床病理学特征、免疫表型、诊断及预后。方法回顾性分析1例TLICC的临床病理学及免疫表型特征,并复习相关文献。结果患者男性,65岁。眼观:部分切除肝组织一块,距肝脏切缘1 cm处见一境界清楚的肿块,大小12 cm×9 cm×7.5 cm,可见包膜,切面灰黄、灰褐色,呈结节状,实性,质中。镜检:肿瘤呈多结节状,可见薄纤维包膜,肿瘤结节内形成大小不等的滤泡样腺腔,腔内含有较多的粉染蛋白分泌物,边缘可见吸收空泡。滤泡样腺腔由单层立方上皮组成,肿瘤细胞形态基本一致,有稀疏的嗜酸性胞质,部分细胞核呈毛玻璃样。免疫表型:肿瘤细胞CK7、CK8/18和CK19均弥漫强阳性,AFP、HepPar1、Glypican-3、Syn、CgA、TTF-1、TG、PAX8和GATA3均阴性。结论 TLICC是新近认识的一种罕见的胆管细胞癌亚型,遇到具有甲状腺滤泡样特征的肝肿瘤时,应考虑甲状腺样肝内胆管细胞癌可能。     

Synchronous double primary gastric and endometrial cancer: a case report and literature review

Multiple primary malignant neoplasms (MPMN) are two or more malignancies in an individual without any relationship between the tumors. In recent years, increasing number of cases were reported. However, Synchronous double primary gastric and endometrial cancer are relatively rare to be reported. Here we present a rare case of synchronous double cancer involving the stomach and endometrium, which is resected simultaneously and received six times chemo. After reviewing lots of literatures at home and abroad, we discuss the risk factors, the diagnostic criteria, the treatment modalities and the prognosis of these rare MPMN. Although a number of risk factors have been proposed in a mass of literatures, but the mechanism of MPMN is still unclear. We didn’t discover a detailed explanation for the mechanism of MPMN from our patient. Therefore, further research should focus on the etiology and mechanism of MPMN.     

Simultaneous double primary clear cell carcinomas of liver and kidney: a case report and review of literature

Reported herein are simultaneous double primary clear cell carcinomas arising from liver and kidney. A 63-year-old man underwent a partial wedge nephrectomy of the right kidney in a surgical resection for hepatocellular carcinoma. Coincidently, on histology the tumors in liver and kidney were consisted of clear cancer cells, which arranged in haphazardly intermixed pattern without capsules. Immunohistochemically, the clear neoplastic cells in the liver were positive for HepPar-1, GPC3, and negative for nephrogenic markers; however, renal clear neoplastic cells were positive for CD10, RCC and Pax-8, but negative to liver-derived markers. These findings led to the diagnosis of simultaneous double primary clear cell carcinomas of kidney and liver. Multiple primary carcinomas of kidney and liver, especially both are primary clear cell carcinomas, are extremely rare neoplasms, only 1 case has been reported previously until now. To our knowledge, this is a report of multiple primary carcinomas arising from the liver and kidney and reminders us of differentiation diagnosis with carcinoma metastasis.     

Primary squamous cell carcinoma of the stomach: a case report and literature review

Primary squamous cell carcinoma (SCC) of the stomach is rare. Its pathogenesis is also unclear and there are conflicting reports about it in the past. Only about 100 cases have been reported so far in the literature. The current study discusses a new case of gastric squamous cell carcinoma, from a 50-year-old Chinese male patient diagnosed via subtotal gastrectomy with Roux-en-Y reconstruction and D2 lymphadenectomy. In the stomach, an ulcerated mass in the antrum, measuring 12×8×6 cm, was observed. Further, pathological examination of the resected specimen revealed a well-differentiated SCC. Observations indicated tumor cell invasion into the serosa, and encroachment into perigastric regional lymph node. A follow-up abdominal CT scan three months later revealed tumor invasion into the ascending colon. We assume that this invaded mass was transferred from the gastric squamous cell carcinoma. Interestingly, the patient is still alive.     

Acinar cell carcinoma arising in the stomach: a case report with literature review

Acinar cell carcinomas (ACCs) are uncommon malignant tumors of the exocrine pancreas, constituting 1% to 2% of all nonendocrine pancreatic neoplasms. Cases of acinar cell carcinoma developing in heterotopic pancreatic tissue are extremely rare. To the best of our knowledge, no cases of primary ACC developing in the stomach have been reported in the literature. We report the first case of a primary ACC arising in the stomach in an 86-year-old female who presented with a 5-cm gastric submucosal mass with superficial ulceration and a history of anemia. The neoplasm exhibited typical acinar morphology. Immunohistochemical studies demonstrated strong positive reactivity for antitrypsin and antichymotrypsin, and electron microscopy confirmed the presence of zymogen granules. A complete metastatic workup failed to identify any primary pancreatic tumor or other nonpancreatic tumor.     

Ectopic liver tissue in stomach paries: a case report

Ectopic liver (EL) tissue is a rare entity which is reported to occur in several organs such as the gallbladder, pancreas and some other places. The EL tissue is usually detected incidentally during laparoscopy or autopsy, and several potential mechanisms may explain the development of liver ectopia. Although ectopic liver tissue is usually asymptomatic, it develops the same pathologic conditions as orthotopic liver. Although incidental ectopic livers rarely existing and do not have clinical importance, they should be looked for during electron microscope scan and histopathological examination should be carried out to rule out pathological changes since development of hepatocellular carcinoma is a possible issue. In this article, we presented an EL tissue in stomach of which only two cases were reported previously and this is the first reported case of a laparoscopically treated EL which lies to the bottom submucosal of the stomach. It would seem sensible to resect the ectopic tissue under endoscopic and the patient was well when seen for follow-up three months later.     

Synchronous double cancers of colonic large cell neuroendocrine carcinoma and gastric squamous-cell carcinoma: a case report and review of literature

Either colonic large cell neuroendocrine carcinoma (LCNEC) or gastric squamous-cell carcinoma (SCC) is extremely rare, with a very poor prognosis due to the high rate of distant metastases. Here, we report the first case of synchronous double malignancies in form of colonic LCNEC and gastric SCC. A 66-year male underwent a right hemicolectomy for a mass obstructing the ascending colon and an emergent gastroscopic hemostasis for another hemorrhagic stomach mass. Histopathological examination confirmed colonic LCNEC displaying the characteristic of large, vesicular nuclei with variable amounts of cytoplasm and gastroscopic biopsy revealed poorly-differentiated gastric SCC. Immunohistochemical staining of LCNEC demonstrated positive activities for chromogranin A, synaptophysin, CD56, NSE, ki-67 (>95%), but negative for CD99, CK20 and TTF-1. The patient had suffered from an accelerated growth of multiple liver metastases after surgery, suggestive of concomitant tumor resistance (CR), and survived 2 months after discharge.     

Primary adenosquamous carcinoma of the liver: a case report and review of the literature

Primary adenosquamous carcinoma of the liver is a rare subtype of cholangiocarcinoma. Adenosquamous carcinoma, which consists of both adenocarcinoma and squamous cell carcinoma components. A 73-year-old woman was admitted to our hospital with a 1-year history of anorexia and general fatigue. Abdominal computed tomography (CT) disclosed a mass, 8 cm in diameter, with low-density located and central necrosis in the right lobe segment of the liver. Because of the rapid development of the liver tumor, the patient died of liver failure 10 months after the surgery.     

原发性子宫内膜鳞癌1例报道及文献复习

目的探讨子宫内膜鳞癌的临床病理特点。方法对1例原发性子宫内膜鳞癌进行免疫组化观察并结合文献复习其临床病理特点。结果原发性子宫内膜鳞癌镜下为伴角化珠及间桥的高分化鳞癌，浸润子宫壁肌层内2／3，淋巴管见多发性瘤栓。子宫颈和颈管正常。免疫表型：高分子CK( )、低分子CK( )、ER( )、PR( )、HPV胞质阳性、p53( )及P-gp( )。结论原发性子宫内膜鳞癌非常罕见，恶性度高。腺上皮鳞化癌变，可能是其病变过程；HPV的作用还不清楚。该肿瘤术前诊断困难，确诊主要靠术后病理检查。