摘要
目的探讨因儿童胰母细胞瘤(pancreatoblastoma,PB)肝转移而进行肝移植的2例临床资料的病理学特征。方法回顾性分析2例儿童PB多发肝转移的临床病理及免疫表型特征,采用免疫组化法对2例进行检测并随访,探讨肝移植能否作为晚期儿童PB治疗的新方案。结果2例PB均以肝脏病灶为首发伴AFP升高,经影像学检查发现胰腺肿物,病理穿刺提示PB肝转移,经化疗后无明显缓解,行胰、十二指肠切除及肝移植术后,常规病理检查为PB并肝脏多发转移(Ⅳ期)。免疫表型:肿瘤细胞同时表达AACT、CK、CK5/6、CD10、β-catenin及神经内分泌标记(Syn、Cg A等)。术后随访患者肝功能均正常,无肿瘤复发及转移。结论儿童PB晚期发生肝转移时,肝脏转移灶的病理形态学特征及免疫组化表达与胰腺原发灶基本一致,对于肝脏多发转移的患者,经过肝移植可以获得较好的预后。
Objective To analyzes the clinical and pathological characteristics of liver transplantation in 2 children with pancreatoblastoma(PB)liver metastasis.Methods The clinicopathological and immunophenotypic features of 2 children with multiple liver metastasis of PB were analyzed retrospectively.Two cases were detected and followed up by immunohistochemical method,and the related literatures were reviewed to explore whether liver transplantation can be used as a new treatment for advanced PB in children.Results In the 2 cases of PB,the focus of liver was elevated AFP at the begining,pancreatic mass was found by imaging examination,pathological puncture showed liver metastasis of PB,and there was no obvious remission after chemotherapy.After pancreaticoduodenectomy and liver transplantation,routine pathological examination showed PB with multiple liver metastasis(stageⅣ).Immunophenotype:tumor cells simultaneously expressed AACT,CK,CK5/6,CD10,β-catenin and neuroendocrine markers(Syn,CgA,etc.).During the follow-up,the liver function was normal and there was no tumor recurrence and metastasis.Conclusion When liver metastasis occurs in children with advanced PB,the pathomorphological characteristics and immunohistochemical expression of liver metastasis are basically consistent with the primary focus of pancreas.For patients with multiple liver metastasis,better prognosis can be obtained after liver transplantation.
作者
王烨
展晓红
李祎南
赵静
蔡文娟
Wang Ye;Zhan Xiaohong;Li Yinan;Zhao Jing;Cai Wenjuan(Department of Pathology,The Affiliated Hospital of Qingdao University,Qingdao 266100,Shandong,China;Department of Pathology,Tianjin First Central Hospital,Tianjin 300192,China;Department of Pathology,Affiliated Qingdao Central Hospital of Qingdao University,Qingdao Cancer Hospital,Qingdao 266100,Shandong,China)
出处
《实用器官移植电子杂志》
2023年第5期436-440,共5页
Practical Journal of Organ Transplantation(Electronic Version)
关键词
胰母细胞瘤
肝转移
肝移植
临床病理特征
免疫组织化学
Pancreatoblastoma
Liver metastasis
Liver transplantation
Clinicopathological features
Immunohistochemistry
