A carcinoma displaying undifferentiated features with dense lymphoplasmacytic infiltration is defined as a lymphoepithelioma-like carcinoma(LEC),and some of LEC is associated with Epstein-Barr virus(EBV).All of the 13...A carcinoma displaying undifferentiated features with dense lymphoplasmacytic infiltration is defined as a lymphoepithelioma-like carcinoma(LEC),and some of LEC is associated with Epstein-Barr virus(EBV).All of the 13 previously reported cases of LEC of the biliary system were intrahepatic in location.Herein,we describe the first case of LEC of the inferior common bile duct.A 68-year-old Japanese man,who had been previously treated for hepatocellular carcinoma using microwave coagulation therapy,was found to have tumors of the common bile duct and pancreas head.Histopathological study of the resected tumor showed solid or cohesive nests of large undifferentiated cells with irregular large vesicular nuclei and nucleoli.Around the tumor cell nests,dense lymphoplasmacytic infiltration was observed.Focal glandular differentiation(approximately 5%) was also present.These histopathological features corresponded morphologically to LEC.Immunohistochemically,the tumor cells were positive for cytokeratin(CK) 7,CK 19 and CA19-9,but negative for CK 20 and Hep Par 1.In situ hybridization for Epstein Barr virus early small RNAs disclosed no nuclear signal in tumor cells.Therefore,a diagnosis of non-EBV-associated LEC of the inferior common bile duct was made.Although the prognosis of the biliary LEC is thought to be better than that of conventional cholangiocarcinoma,the differences in prognosis between EBV-positive and-negative cases have not yet been established.Therefore,additional case studies will be needed to clarify the clinicopathological features of LEC of the biliary tract.展开更多
Reactive lymphoid hyperplasia(RLH) of the liver is an extremely rare lesion characterized by the proliferation of non-neoplastic lymphocytes forming follicles.Hepatic RLH is known to be associated with gastrointestina...Reactive lymphoid hyperplasia(RLH) of the liver is an extremely rare lesion characterized by the proliferation of non-neoplastic lymphocytes forming follicles.Hepatic RLH is known to be associated with gastrointestinal carc inoma and autoimmune diseases including primary biliary cirrhosis(PBC).We report a case of hepatic RLH in a patient with PBC and gastric cancer.A 68 year old Japanese woman with a 10 year history of liver enzyme abnormality was admitted.Laboratory testing revealed that her anti-mitochondrial antibody was markedly elev ated.Five mo after the diagnosis of PBC,she was foun d to have gastric cancer.Abdominal computed tom og raphy disclosed a liver nodule in S8,suggesting metas tatic gastric carcinoma.Histopathologically,the resected liver lesion comprised of a nodular proliferation of small lym phocytes with lymphoid follicles.This is the first reported case of hepatic RLH in a patient with both PBC and gastric cancer.Pre-operative diagnosis of hepatic RLH by clinical imaging is extremely difficult.Therefore,a need le biopsy could be useful to make a diagnosis of hepat ic RLH,especially to differentiate from metastatic gastroin t estinal carcinoma.展开更多
We report a case of hepatocellular carcinoma (HCC) occurring in a patient with Crohn’s disease (CD) without chronic hepatitis or liver cirrhosis, and review the clinicopathological features of HCC in CD patients. A 3...We report a case of hepatocellular carcinoma (HCC) occurring in a patient with Crohn’s disease (CD) without chronic hepatitis or liver cirrhosis, and review the clinicopathological features of HCC in CD patients. A 37-year-old Japanese man with an 8-year history of CD and a medication history of azathioprine underwent resection of a liver tumor. The histopathology of the liver tumor was pseudoglandular type HCC. In the nonneoplastic liver, focal hepatocyte glycogenosis (FHG) was observed, however, there was no evidence of liver cirrhosis or primary sclerosing cholangitis. Only nine cases of HCC in CD patients have been reported previously in the English-language literature. Eight of 10cases (including the present case) had received azathioprine treatment, and four of these cases also showed FHG, which is considered a preneoplastic liver lesion, within the non-neoplastic liver. Although the precise mechanism of the development of HCC in CD patients is controversial, these results suggest that azathioprine therapy and FHG in the non-neoplastic liver contribute to the development of HCC. These findings also indicate that it is important to survey CD patients treated with prolonged azathioprine therapy for potential liver tumors.展开更多
Hidroacanthoma simplex(HAS) is a rare skin appendage tumor and is recognized as an intraepidermal variant of poroma. Pigmented HAS is an extremely rare variant with dendritic melanocytes and/or melanin pigment in the ...Hidroacanthoma simplex(HAS) is a rare skin appendage tumor and is recognized as an intraepidermal variant of poroma. Pigmented HAS is an extremely rare variant with dendritic melanocytes and/or melanin pigment in the tumor cells and a few cases of pigmented HAS have been reported in the English literature. We herein report a case of pigmented HAS and discuss the clinicopathological features of pigmented HAS and the pitfall in the diagnosis of black lesions.展开更多
文摘A carcinoma displaying undifferentiated features with dense lymphoplasmacytic infiltration is defined as a lymphoepithelioma-like carcinoma(LEC),and some of LEC is associated with Epstein-Barr virus(EBV).All of the 13 previously reported cases of LEC of the biliary system were intrahepatic in location.Herein,we describe the first case of LEC of the inferior common bile duct.A 68-year-old Japanese man,who had been previously treated for hepatocellular carcinoma using microwave coagulation therapy,was found to have tumors of the common bile duct and pancreas head.Histopathological study of the resected tumor showed solid or cohesive nests of large undifferentiated cells with irregular large vesicular nuclei and nucleoli.Around the tumor cell nests,dense lymphoplasmacytic infiltration was observed.Focal glandular differentiation(approximately 5%) was also present.These histopathological features corresponded morphologically to LEC.Immunohistochemically,the tumor cells were positive for cytokeratin(CK) 7,CK 19 and CA19-9,but negative for CK 20 and Hep Par 1.In situ hybridization for Epstein Barr virus early small RNAs disclosed no nuclear signal in tumor cells.Therefore,a diagnosis of non-EBV-associated LEC of the inferior common bile duct was made.Although the prognosis of the biliary LEC is thought to be better than that of conventional cholangiocarcinoma,the differences in prognosis between EBV-positive and-negative cases have not yet been established.Therefore,additional case studies will be needed to clarify the clinicopathological features of LEC of the biliary tract.
文摘Reactive lymphoid hyperplasia(RLH) of the liver is an extremely rare lesion characterized by the proliferation of non-neoplastic lymphocytes forming follicles.Hepatic RLH is known to be associated with gastrointestinal carc inoma and autoimmune diseases including primary biliary cirrhosis(PBC).We report a case of hepatic RLH in a patient with PBC and gastric cancer.A 68 year old Japanese woman with a 10 year history of liver enzyme abnormality was admitted.Laboratory testing revealed that her anti-mitochondrial antibody was markedly elev ated.Five mo after the diagnosis of PBC,she was foun d to have gastric cancer.Abdominal computed tom og raphy disclosed a liver nodule in S8,suggesting metas tatic gastric carcinoma.Histopathologically,the resected liver lesion comprised of a nodular proliferation of small lym phocytes with lymphoid follicles.This is the first reported case of hepatic RLH in a patient with both PBC and gastric cancer.Pre-operative diagnosis of hepatic RLH by clinical imaging is extremely difficult.Therefore,a need le biopsy could be useful to make a diagnosis of hepat ic RLH,especially to differentiate from metastatic gastroin t estinal carcinoma.
文摘We report a case of hepatocellular carcinoma (HCC) occurring in a patient with Crohn’s disease (CD) without chronic hepatitis or liver cirrhosis, and review the clinicopathological features of HCC in CD patients. A 37-year-old Japanese man with an 8-year history of CD and a medication history of azathioprine underwent resection of a liver tumor. The histopathology of the liver tumor was pseudoglandular type HCC. In the nonneoplastic liver, focal hepatocyte glycogenosis (FHG) was observed, however, there was no evidence of liver cirrhosis or primary sclerosing cholangitis. Only nine cases of HCC in CD patients have been reported previously in the English-language literature. Eight of 10cases (including the present case) had received azathioprine treatment, and four of these cases also showed FHG, which is considered a preneoplastic liver lesion, within the non-neoplastic liver. Although the precise mechanism of the development of HCC in CD patients is controversial, these results suggest that azathioprine therapy and FHG in the non-neoplastic liver contribute to the development of HCC. These findings also indicate that it is important to survey CD patients treated with prolonged azathioprine therapy for potential liver tumors.
文摘Hidroacanthoma simplex(HAS) is a rare skin appendage tumor and is recognized as an intraepidermal variant of poroma. Pigmented HAS is an extremely rare variant with dendritic melanocytes and/or melanin pigment in the tumor cells and a few cases of pigmented HAS have been reported in the English literature. We herein report a case of pigmented HAS and discuss the clinicopathological features of pigmented HAS and the pitfall in the diagnosis of black lesions.
