Localized malignant mesothelioma of the epithelial type occurring as a primary hepatic neoplasm: a case report with review of the literature.
Localized malignant mesothelioma of the epithelial type occurring as a primary hepatic neoplasm: a case report with review of the literature.
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作为原发性肝肿瘤发生的上皮型局限性恶性间皮瘤：病例报告及文献综述。
DOI：
10.1034/j.1600-0463.2002.t01-1-1101102.x
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发表时间：
2002
期刊：
影响因子：
--
通讯作者：
T. Fujimori
中科院分区：
文献类型：
--
作者：
J. Imura;K. Ichikawa;J. Takeda;Y. Iwasaki;S. Tomita;K. Kubota;T. Fujimori
我们报告了一名 64 岁男性的原发性肝肿瘤，为上皮型局限性恶性间皮瘤。他被发现肝脏右叶有肿块。手术切除了右肝叶的肿块，并部分切除了膈肌。大体上，肝实质中存在边界不清的肿瘤。组织学上，肿瘤显示出主要的管状生长模式，并具有促纤维增生性基质。小管内衬有单层立方形或扁平细胞，具有多形性泡状核。在管腔和肿瘤细胞质中发现了透明质酸酶可消化的粘蛋白样物质。肿瘤细胞的钙视网膜蛋白、HBME-1、细胞角蛋白（即 AE1/AE3 和 CAM 5.2）免疫组织化学阳性，但癌胚抗原、CD 34 和 Leu M1 阴性。此外，肿瘤细胞显示p53癌蛋白的核积聚，并频繁与Ki-67抗体发生反应。这些发现支持上皮型恶性间皮瘤可能发生在胸膜外部位的概念。据我们所知，这是首例报道的肝脏局部恶性原发性间皮瘤病例。
We report a localized malignant mesothelioma of the epithelial type, occurring as a primary hepatic neoplasm in a 64-year-old male. He was found to have a mass located in the right lobe of the liver. Surgery was carried out with resection of the mass from the right hepatic lobe, with partial resection of the diaphragm. Grossly, an ill-defined tumor was present in the hepatic parenchyma. Histologically, the tumor displayed a predominant tubular pattern of growth with a desmoplastic stroma. The tubules were lined by a single layer of cuboidal or flattened cells with pleomorphic vesicular nuclei. A hyaluronidase-digestible, mucin-like substance was demonstrated in the lumen and tumor cytoplasm. The tumor cells were immunohistochemically positive for calretinin, HBME-1, cytokeratin, i.e. AE1/AE3 and CAM 5.2, but negative for carcinoembryonic antigen, CD 34 and Leu M1. Moreover, the tumor cells showed nuclear accumulation of the p53 oncopotein and reacted frequently with Ki-67 antibody. These findings support the concept that malignant mesothelioma of the epithelial type may occur at extrapleural sites. To the best of our knowledge, this is the first reported case of localized malignant primary mesothelioma arising in the liver.