肉腫様肝内胆管癌と肉腫様肝細胞癌の2症例

Abstract

Two cases of sarcomatous HCC and CCC are reported. One patient, a 72-year old female, had a 3.5 cm tumor in the lateral segment of the liver. The other, a 64-year old male, had a 5.5 cm tumor in the anterior to posterior segment of the liver. Both tumors were surgically removed. Histologically, both tumors were mainly composed of atypical spindle-shaped sarcomatous or pleomorphic cells arranged in bundles and/or sheets, together with a minor component of carcinoma elements of CCC in the former case and HCC in the latter. Abundant inflammatory cell infiltration was observed in both tumors. There were transitional zones between the carcinomatous and sarcomatous elements in both cases. Immunohistochemically, sarcomatous cells of the former were positive for vimentin, CAM5.2, CK7, CK19, and AE1/AE3, but negative for hepatocyte specific antigen (HSA), anaplastic lymphoma kinase (ALK), α-SMLA, desmin and S100. Finally a diagnosis of sarcomatous CCC was made. Sarcomatous cells of the latter were positive for vimentin, CAM5.2, AE1/AE3, and CK18, but were negative for CK7, CK19, CK20, HSA, AFP, ALK, α-SMA, desmin, and S100, and were finally diagnosed as a sarcomatous HCC.