가성육종성 변형을 보이는 병합형 간세포-담관암 - 1예 보고 -
A Case of Combined Hepatocellular Carcinoma-Cholangiocarcinoma with Pseudosarcomatous Features
신옥란, 임근우, 최영진, 박재영, 이혜경, 김기환, 구영미,
소속 상세정보
신옥란 ( Shin Ok-Ran )
가톨릭대학교 의과대학 병원병리학교실
임근우 ( Lim Keun-Woo )
가톨릭대학교 의과대학 외과학교실
최영진 ( Choi Young-Jin )
가톨릭대학교 의과대학 병원병리학교실
박재영 ( Park Jae-Young )
가톨릭대학교 의과대학 안과학교실
이혜경 ( Lee Hae-Kyung )
가톨릭대학교 의과대학 진단검사의학교실
김기환 ( Kim Kee-Hwan )
가톨릭대학교 의과대학 외과학교실
구영미 ( Ku Young-Mi )
가톨릭대학교 의과대학 영상의학교실
KMID : 0357920060400040303
Abstract
Combine hepatocellular-cholangiocarcinoma with pseudosarcomatous features is a rare primary liver tumor. We report a 46-year-old man who is a carrier of HBV and has presented intermittent severe abdominal pain on right upper quadrant for 6 days. Tumor markers, alpha-fetoprotein, CEA and CA19-9 were within normal ranges. Abdominal computed tomogram revealed a large heterogeneous mass in the posteroinferior segment of right liver without associated biliary dilatation and conglomerated, enlarged portocaval and peripancreatic lymph nodes. Right hepatectomy was performed with local lymph node dissection. The tumor, measuring 7.5×5.5 cm showed an ill demarcated round to oval shape and a variegated whitish yellow solid cut surface with necrosis. Microscopically, the tumor consisted of three components, hepatocellular carcinoma, cholangiocarcinoma and undifferentiated sarcomatoid tumor cells. Immunohistochemically, hepatocellular carcinoma portion reacted positively with alpha-fetoprotein, cholangiocarcinoma portion reacted positively with bile duct-type cytokeratins (cytokeratin 7 and 19) and EMA. The pseudosarcomatous portion reacted with bile duct type cytokeratins and EMA. These findings suggested that pseudosarcomatous tumor cells may be with closely, associated primitive stem cells that can differentiate into the ductal epithelium.
키워드
Carcinoma; Hepatocellular;Cholangiocarcinoma;Sarcomatoid carcioma
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