原发性肝及胆囊神经内分泌肿瘤

Primary neuroendocrine tumors of liver and gallbladder

收集了1例经尸体解剖证实的肝及2例外科手术切除胆囊的神经内分泌肿瘤。应用组织学、免疫组织化学和电子显微镜对其肿瘤病理特点进行了观察。免疫组化第一抗体包括抗－嗜铬蛋白A、胃泌素、五羟色氨、胰岛素、生长抑素、胰多肽、肾上腺皮质激素（ACTH）、降钙素、蛙皮素、β绒毛膜促性腺激素（β－HCG）。结果发现1例发生在胆囊的为典型类癌；另两侧诊断为神经内分泌癌分别发生在肝和胆囊。在免疫组织化学中，3例肿瘤大部分细胞（50％以上）对嗜铬蛋白A呈阳性反应。并在肿瘤细胞中分别发现胃泌素、五羟色氨、胰岛素和胰多肽阳性细胞。电子显微镜显示胞浆内含有电子致密圆颗粒。结合文献对肝及胆囊的神经内分泌癌的临床病理特点、神经内分泌癌的分类命名及组织来源进行了探讨。

The clinico-pathological characters of 3 cases with neuroendocrine carcinoma of liver and gallbladder were studied by using histological, immunohistochemical methods and electron microscopy. The primary antibodies including anti-chromogranin A, serotonin, insulin, somatostatin, gastrin, pancreatic polypeptide, adreno-corticotropic hormone (ACTH), calcitonin, bombesin, β-human chorionic gonadotropin (β-HCG) were employed to identify the property of tumors. The tumors in two cases were neuroendocrine carcinoma including one in the gallbladder and another one in the liver. The tumor in the third case occurring in the gallbladder is a typical carcinoid.In the immunohistochemistry study, the tumor cells showed positive reaction to chromogranin A and contained positive cells of gastrin, serotonin, insulin and pancreatic polypeptide. Electron microscopic examinations showed that the cytoplasm contained dense round granules. The neuroendocrine carcinoma of liver and gallbladder is a special type neoplasm. With references in the literature, its clinicopathological characteristics, classification, nomenclature and histogenesis were discussed.