胆囊癌肉瘤临床病理观察及文献复习

目的 探讨胆囊癌肉瘤的临床病理特征、诊断及鉴别诊断.方法 分析1例胆囊癌肉瘤的临床表现,对标本进行组织病理学和免疫组织化学(EnVisonTM)染色观察,并复习文献,了解该肿瘤的特征.结果 大体检查肿瘤呈质硬灰白色肿块.镜检显示病变上皮性源肿瘤成份和间叶源性肿瘤成份并存,癌和肉瘤之见无移行现象.免疫组织化学上皮源性肿瘤成份CK( )、EMA( )、Vim(-);间叶源性肿瘤成份Vim( )、CK(-)、EMA(-).两者CD34(-)、CD68(-)、SMA(-)、Des(-)、CD117(-)、S-100(-)、MyoD1(-).结论 原发于胆囊的癌肉瘤较罕见,诊断需与胆囊未分化癌及胆囊腺肌瘤病等鉴别.免疫组织化学CK、EMA等标记对鉴别诊断有帮助.

Clinicopathologic study of carcinosarcoma of the gallbladder and review of the literature

Objective To investigate the clinical and pathological features of gallbladder carcinosarcoma and its differential diagnosis.Methods The clinical findings,histopathology and immunohistochemistry (EnVisionTM) of a gallbladder carcinosarcoma was studied and the relative literature were reviewed in order to understand the characteristics of the tumor. Results Macroscopically,the tumor appeared as a hard grayish-white mass.Histopathology showed neoplasm of carcinoma and sarcoma .Between carcinoma and sarcoma it showed no transitional areas.Immunohistochemical study showed that the malignant epithelial component expressed CK, EMA and CEA,negative for vimentin.The malignant mesenchymal component were positive for Vimentin,negative for CK and EMA . Conclusion Primary carcinosarcoma of gallbladder is a rare tumor.More attention should be paid in the daily practice in order to differentiate this tumor form adenomyomatosis and undifferentiated carcinoma(Scarcimationd carcimoma) of the gallbladder .Immunohistochemical staining for CK and EMA is helpful in confirming the diagnosis.