위의 간양 선암종 -1예 보고-
Hepatoid Adenocarcinoma of Stomach -A case report-
소속 상세정보
심정원/Jung Weon Shim
안혜경/이영철/김주섭/박영의/Hye Kyung Ahn/Young Cheol Lee/Joo Seop Kim/Young Euy Park
KMID : 0357919940280060666
Abstract
위의 간양 선암종은 1985년 Ishikura등이 많은 양의 alpha fetoprotein(AFP)을 생산하면서
조직학적으로 선암종과 간암종의 분화가 동시에 존재하는 위의 원발성 암종으로 보고한 이
래 간 전이가 흔하게 동반되면서 예후가 나쁜 암종으로 알려져 왔다. 이후 1986년에는 역시
Ishikura등이 AFP의 생산 없이도 간암종의 조직학적 특성을 보이는 암종도 포함시켜야 한
다고 주장한 바있다. 저자들은 위의 간양 선암종 1예를 문헌고찰과 함께 보고하고자 한다.
#초록#
A case of primary gastric carcinoma with patterns resembling those of hepatocellular
carcinoma(HCC) is reported. This patient who represented high serum
alpha-fetoprotein(AFP) under-went a subtotal gastrectomy for stomach cancer and
lobectomy of liver metastasis. The hepatoid component of the tumor was characterized
by solid nests of large polygonal cells arranged in cords and trabeculae, with central
nuclei, prominent nucleoli, and abundant eosinophilic cytoplasm; single-nuclear giant cells
were frequently noted. These tumor cells of stomach stained positive
immunohistochemically for AFP, ACT(alpha-1-antitrypsin),
AACT(alpha-1-antichy-motrypsin). Thus, this hepatoid gastric adenocarcinoma tumor
cells demonstrated both morphologic and immunohistochemical features of partial
differentiation to the HCC. Careful histologic examination in conjunction with the
immunohistochemical demonstration of AFP can provide a useful contribution to the
diagnosis of this rare histological type of gastric carcinoma. And the presence of
metastatic hepatoid adenocarcinoma from the stomach should be considered in a patient
with hepatic tumor mimicking HCC. Because of frequent venous and lymphatic invasion,
as well as liver metastasis, prognosis appears to be poor. The authors reviewed 45
cases of hepatoid adenocarcinoma of stomach reported in the literature, also. (Korean J
Pathol 1994; 28: 666∼668)
키워드
Hepatoid adenocarcinoma; stomach; AFP; Liver metastasis;
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