肝细胞性淋巴上皮瘤样癌3例及文献复习

Hepatocellular lymphoepithelioma-like carcinoma:A report of 3 cases and review of literature

目的探讨肝细胞性淋巴上皮瘤样癌的临床病理学特点。方法通过HE、免疫组化染色对3例肝组织中肝细胞性淋巴上皮瘤样癌进行形态学观察。结果瘤细胞异型明显,呈小灶状分布,细胞呈多边形,核居中央,有一清楚核仁,细胞质丰富,嗜酸性,可见细小颗粒,易见核分裂象。肿瘤间质内见大量成熟的淋巴细胞浸润,且分散在瘤细胞之间。3例中肿瘤细胞CK7、Hepatocyte、EB(-),CK8、AFP(+),而间质中淋巴细胞CD45(+)、小B淋巴细胞CD20(+)、小T淋巴细胞CD45RO(+)。结论肝细胞性淋巴上皮瘤样癌是一种少见的肝上皮源性恶性肿瘤,其诊断主要依靠组织病理学和免疫组化标记。

Purpose To investigate the clinicopathological characteristics of hepatocellular lymphoepithelioma-like carcinoma. Methods Three cases of hepatocellular lymphoepithelioma-like carcinoma were studied by light microscopy and immunohistochemistry. Resuits The tumor cells were sporadic and polygonal with a central nucleus containing prominent nucleoli. The cytoplasm of tumor cells was abundant, eosinophilic and sometimes granular. Massive lymphocytes infiltrated into tumor tissue, which were small and were closely associated with tumor cells. Immunohistochemical staining showed strong positive expression of CK8 and AFP in the tumor cells, but no expression for CK7, hepatocyte protein and EB virus. Mature T and B lymphocytes expressed CD45 RO and CD20, respectively. Conclusions Hepatocellular lymphoepithelioma-like carcinoma is an uncommon malignant epithelial tumor, and its diagnosis mainly depends on histopathology and immunohistochemistry.