摘要
目的:分析胆囊小细胞癌的形态学和免疫组化特征。方法:对3例胆囊小细胞癌组织进行临床病理和免疫组化分析,并结合文献讨论其诊断及鉴别诊断。结果:3例胆囊小细胞癌患者均为中老年女性,年龄分别为62、75、42岁,其临床表现均为餐后右上腹钝痛。例1属胆囊单纯型小细胞癌,病理检查提示为小圆细胞肿瘤浸润肌层伴明显坏死,肿瘤细胞排列紧密,呈实性片块状、灶性巢状、束状排列;高倍镜下细胞核呈圆形、卵圆形,染色质细颗粒状,胞质稀少,有时可见"Azzopardi效应"。例2、例3肿瘤组织镜下呈实性或小梁状排列,细胞呈燕麦状或短梭形,部分区域伴有低分化腺癌和印戒细胞癌,属于胆囊混合型小细胞癌。免疫组化染色显示肿瘤细胞表达上皮及神经内分泌双重标志。结论:胆囊小细胞癌非常罕见,根据组织学特征和免疫组化染色结果可与其他小圆细胞肿瘤相鉴别。
Objective To study the morphology and immunohistochemistry characteristics of small cell carcinoma（SCC） of gallbladder.Methods Three cases of SCC were analyzed for clinicopathological and immunohistochemical characteristics with review of literature.Results The patients were aged 62,75 and 42,respectively,with the complaint of a history of crampy right upper quadrant pain aggravated by meals.Histologically,case 1 showed a typical appearance of pure SCC of gallbladder with small round cells densely packed and arranged in sheet-like and foci in cordsornests pattern and with muscular invasion and obvious necrosis.On high-power view,the tumor cells were presented as having round and/or oval nuclei with scant cytoplasm and fine granular chromatin.Sometimes a special phenomenon of ＂crush artifact＂ might be observed that was termed as the ＂Azzopardi＇s effect＂.Meanwhile,case 2 and case 3 were of mixed type SCC displaying a combined structure that the fusiformoroat-like tumor cells with fine chromatin and brisk mitosis were arranged in solid or trabecula pattern and accompanied with poor-differentiated adenocarcinoma and signal ring cell carcinoma in some areas.Immunohistochemically,all three cases were positive for both epithelial and endocrine markers.Conclusions SCC of gallbladder is a rare malignant tumor.It can be differentiated from other small round cell neoplasms based on histopathological features and immunohistochemical findings.
出处
《诊断学理论与实践》
2011年第6期535-539,共5页
Journal of Diagnostics Concepts & Practice
关键词
胆囊肿瘤
小细胞癌
临床病理
免疫组化
鉴别诊断
Gallbladder neoplasms
Small cell carcinoma
Clinicopathology
Immunohistochemistry
Differential diagnosis
