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目的探讨肺原发性肝样腺癌的临床病理特征、免疫表型、诊断和鉴别诊断。方法对2014年1月收集的1例肺原发性肝样腺癌的临床表现、大体及组织学形态、免疫组化等进行观察研究,并复习相关文献。结果患者为64岁吸烟男性,因咳嗽、咯血8 d入院。肿物大体呈卵圆形,切面灰白,境界清楚;镜下具有肝细胞癌样和腺癌分化特征,间质可见丰富的血窦。免疫组化示肿瘤细胞Hepatocyte、AFP、CK8/18、CK19、CK(pan)阳性;而CK7、CK14、CK5/6、TTF-1、CEA、Vimentin等阴性。结论肺肝样腺癌是原发于肺的上皮性恶性肿瘤,诊断的确立主要依赖发现相似于肝细胞癌的形态(肝样结构),并通过临床病理与免疫组化检测除外肝细胞癌等疾病的转移。
Objective To investigate the clinicopathological characteristics, immunophenotype, diagnosis and differential diagnosis of primary hepatofacial adenocarcinoma of the lung. Methods The clinical manifestations, gross and histological features and immunohistochemistry of one case of primary hepatofacial adenocarcinoma collected in January 2014 were observed and reviewed. Results The patient was a 64-year-old smoker and was hospitalized for 8 days on cough and hemoptysis. Ovarian tumor roughly oval, gray section, the realm of clear; microscopic features of hepatocellular carcinoma and adenocarcinoma differentiation, stroma can be seen rich sinusoids. Immunohistochemistry showed that Hepatocyte, AFP, CK8 / 18, CK19 and CK (pan) were positive, while CK7, CK14, CK5 / 6, TTF-1, CEA and Vimentin were negative. Conclusions Pulmonary and hepatic adenocarcinoma is a primary epithelial malignant tumor of the lung. The diagnosis is mainly based on the finding of a morphology similar to that of hepatocellular carcinoma (hepatic-like structure) and the detection of diseases such as hepatocellular carcinoma by clinicopathological and immunohistochemical methods The transfer.