Pure squamous cell carcinoma of the gallbladder locally invading the liver and abdominal cavity: A case report and review of the literature

BACKGROUND Gallbladder squamous cell carcinoma(GBSCC)is a rare subtype of malignancy and accounts for only 2%-3%of gallbladder malignancies.Due to its rapid development,most patients with GBSCC initially present with an advanced stage of the disease and hence a poor prognosis.The clinicopathological and biological features of SCC remain to be fully elucidated,owing to its uncommon occurrence.The majority of currently available data only described individual case reports or series analyses of trivial cases.CASE SUMMARY A 64-year-old man was admitted for progressively poor abdominal distension and pain.Liver computed tomography(CT)showed infiltration of gallbladder carcinoma into the adjacent liver,and enlarged retroperitoneal lymph nodes.The patient underwent radical cholecystectomy.Part of the mass was grey and soft,and the neoplastic section showed a purulent-necrotic lesion.Hematoxylin and eosin staining revealed a moderately differentiated SCC.Immunohistochemical studies showed strong staining of the tumor for AE1/3 and CK5/6.Staining for CK19,CK7,and CAM5.2 was positive in the cytoplasm.Systemic chemotherapy was not administered because of the patient’s poor physical condition.After five months,CT and magnetic resonance cholangiopancreatography showed multiple metastases in the liver and abdominal cavity.CONCLUSION Squamous components of GBSCC may explain the complex biological behavior,and CD109 may be involved in the pathogenesis.

Phenotypic changes of human cells in human-rat liver during partial hepatectomy-induced regeneration

AIM: To examine the human hepatic parenchymal and stromal components in rat liver and the phenotypic changes of human cells in liver of human-rat chimera (HRC) generated by in utero transplantation of human cells during partial hepatectomy (PHx)-induced liver regeneration. METHODS: Human hepatic parenchymal and stromal components and phenotypic changes of human cellsduring liver regeneration were examined by flow cytometry, in situ hybridization and immunohistochemistry. RESULTS: ISH analysis demonstrated human Alupositive cells in hepatic parenchyma and stroma of recipient liver. Functional human hepatocytes generated in this model potentially constituted human hepatic functional units with the presence of donor-derived human endothelial and biliary duct cells in host liver. Alpha fetoprotein (AFP)+, CD34+ and CD45+ cells were observed in the chimeric liver on day 10 after PHxinduced liver regeneration and then disappeared in PHx group, but not in non-PHx group, suggesting that dynamic phenotypic changes of human cells expressing AFP, CD34 and CD45 cells may occur during the chimeric liver regeneration. Additionally, immunostaining for human proliferating cell nuclear antigen (PCNA) showed that the number of PCNA-positive cells in the chimeric liver of PHx group was markedly increased, as compared to that of control group, indicating that donor-derived human cells are actively proliferated during PHx-induced regeneration of HRC liver.CONCLUSION: HRC liver provides a tool for investigating human liver regeneration in a humanized animal model.