右心房孤立性转移性肝细胞癌1例报告及文献复习

目的：探讨右心房孤立性转移性肝细胞癌的临床病理特征。方法：分析1例右心房孤立性移性肝细胞癌的临床表现、组织学特征和免疫组织化学（免疫组化）结果,结合文献分析讨论。结果：患者男性,47岁;活动后胸闷,伴双下肢水肿;组织学显示瘤细胞多边形,呈巢状、片状或条索状排列,可见片状坏死;免疫组化：肝细胞特异性抗原-1（Hepatocyte specific antigen-1,Hep-1）、甲胎蛋白（Alpha fetoprotein,AFP）、细胞角蛋白18（Cytokeratin18,CK18）和癌胚抗原（Carcinoembryonic antigen,CE A）阳性,细胞增殖核抗原（nuclcar-associated antigen Ki-67,Ki-67）阳性标记指数为60%,CD34血窦阳性。结论：右心房孤立性肝细胞癌转移比较罕见,早期症状不明显不易引起注意,依据临床和病理组织学特点,结合免疫组化染色可明确诊断。

A case report and literature review on isolated metastasis of hepatocellular carcinoma in the right atrium

Objective： To discuss the clinical and pathological feature of isolated metastases of hepatocellular carcinoma in the right atrium. Methods： The clinical and histological characteristics and immunohistochemical（IHC） findings were analyzed in one case of isolated metastases of hepatocellular carcinoma in the right atrium through review of the literature. Results： Male patient of 47 years old, presented with chest tightness after activities and bilateral lower leg edema. Tumor cells were polygonal and arranged in nests, flake or cords, with patchy necrosis. IHC showed that tumor cells were positive for Hep-1, AFP, CK18, CEA, Ki-67, Ki-67 labeling index was 60%. Blood sinus was positive for CD34. Conclusion： Isolated metastases of hepatocellular carcinoma in the right atrium are relatively rare. Early symptoms of patients are not obvious and not easy to attract attention. Based on the clinical and histopathological features, combined with IHC staining can make a definite diagnosis.