肝胆管黏液性囊腺瘤的临床病理分析

Clinicopathological features of mucinous hepatobiliary cystadenoma

目的 观察肝胆管黏液性囊腺瘤的临床病理特点 ,探讨该病的诊断及鉴别诊断。方法 回顾分析 5例肝胆管黏液性囊腺瘤的临床表现、组织形态学及免疫表型特征。结果 5例均为女性 ,平均年龄 4 3 4岁。影像学表现为肝内囊性占位。光镜下囊壁内衬黏液柱状上皮 ,3/ 5例上皮下伴有卵巢样间质 ,免疫表型 :上皮细胞CK(AE1/AE3) (5 / 5 )、CK(AE3) (5 / 5 )、EMA(4 / 5 )、CA199(5 / 5 )、PR(1/ 5 )、p5 3(1/ 5 )、E cadherin(2 / 5 )呈阳性表达 ,不表达Ki 6 7及c erbB 2 ;间质细胞vimentin(5 / 5 )、SMA(4 / 5 )及ER(2 / 5 )、PR(3/ 5 )呈阳性表达。结论 肝胆管黏液性囊腺瘤较为罕见 ,好发于中年女性 ,囊壁内衬黏液柱状上皮 ,可伴有卵巢样间质 ,有恶性潜能 ,可以发展为交界性变甚至癌变。手术完整切除预后好。

Purpose To explore the clinicopathological features and differential diagnosis of mucinous hepatobiliary cystadenoma(MHC). Method Five cases of MHC were studied with conventional histopathological and immunohistochemical stains. Results The aveage age of five patients was 43.4 years. MHC was prevalent in women (5/5). The ultrasonography and CT scanning revealed cystic space occupying lesions in the liver. MHC contained the mucinous colummar epithelial cells,which were immunohistochemically positive for CK (AE1/AE3) (5/5), CK (AE3) (5/5), EMA (4/5), CA199 (5/5), PR (1/5), p53 (1/5) and E-cadherin (2/5), and negative for Ki-67 and c-erbB-2. The underlying ovarian-like strom (3/5) were immunoreactive for vimentin (5/5),SMA (4/5), ER(2/5),PR (3/5). Conclusions MHC is an uncommon tumor preferentially involved in middle-age women, containing muious columnar epithelia and ovarian-like stroma. The malignant potential of MHC is stressed, and complete surgical resection is recommended in therapy.