Hepatocellular carcinoma arising from ectopic liver tissue in the spleen producing insulin-like growth factor II
Hepatocellular carcinoma arising from ectopic liver tissue in the spleen producing insulin-like growth factor II
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DOI：
10.1016/j.prp.2010.09.003
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发表时间：
2011-01-01
影响因子：
2.8
通讯作者：
Kuroda, Makoto
中科院分区：
文献类型：
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作者：
Matsuyama, Mutsushi;Sugiura, Seiji;Kuroda, Makoto
我们报告一例与严重低血糖相关的脾肿瘤。患者是一名 69 岁男性，患有巨大脾肿瘤。他患有复发性低血糖发作，并且血糖水平最低（4 mg/dl）。他在出现左腹疼痛症状后 34 个月死亡。尸检发现脾脏有大肿瘤，肺部有3个中等大小的肿瘤，肝脏有几个小肿瘤。脾肿瘤的显微镜研究揭示了肝细胞癌，其对抗PIVKA-II和抗“肝细胞”抗体表现出强烈的阳性反应。在毗邻脾肿瘤的脾被膜中发现了一些被认为是肝组织异位残余物的胆小管。有人认为肿瘤起源于这些小管之一。电镜分析显示，每个肿瘤细胞内都有大量内分泌样颗粒，肿瘤组织中胰岛素样生长因子-II mRNA的表达量比正常肝组织强87-165倍。由于这些结果，我们相信这是第一份关于从脾脏中的肝组织发展而来的肝细胞癌的报告。 (C) 2010 爱思唯尔有限公司。版权所有。
We report a case of splenic tumor associated with severe hypoglycemia. The patient was a 69-year-old man with a large splenic tumor. He had suffered from relapsing hypoglycemic attacks and the lowest serum glucose level (4 mg/dl). He died 34 months after the onset of symptoms of left abdominal pain. Autopsy revealed large tumors in the spleen, 3 medium sized tumors in the lungs, and several small tumors in the liver. Microscopic studies of the splenic tumors revealed a hepatocellular carcinoma which showed a strongly positive reaction against anti-PIVKA-II and anti-"hepatocyte" antibodies. Several bile ductules thought to be heterotopic remnants of the liver tissues were found in the capsule of the spleen, adjoining the splenic tumor. It was suggested that the tumor originated from one of these ductules. Electron microscopic analysis showed numerous endocrine-like granules of every tumor cell, and 87-165 times stronger mRNA expression of insulin-like growth factor-II was measured in the tumor tissues when compared with normal liver tissue. Owing to these results, we believe that this is the first report of hepatocellular carcinoma that had developed from a liver tissue in the spleen. (C) 2010 Elsevier GmbH. All rights reserved.