{"title":"胃肠道两栖癌:5例临床病理研究。","authors":"Hairen Chen, Jinping Chen, Rong Ge","doi":"10.1177/10668969251333111","DOIUrl":null,"url":null,"abstract":"<p><p><i>Objective.</i> To investigate the clinicopathological features, immunophenotype, diagnosis, differential diagnosis, and prognosis of amphicrine carcinoma (AC), a rare tumor characterized by dual differentiation between adenocarcinoma and neuroendocrine carcinoma. <i>Methods.</i> The clinicopathological data of five patients with AC diagnosed by pathology at Ningbo Clinical Pathology Diagnosis Center between 2020 and 2024 were collected. These specimens were analyzed using light microscopy, special staining, and immunohistochemical staining. Relevant literature was also reviewed. <i>Results.</i> The study included four men and one woman (range: 21-80 years) with gastric (3) and colorectal neoplasms (2). In all patients, tumor cells exhibited infiltrative growth, involving the subserosal or the serosal layer. Three tumors showed diffuse growth, with some cells displaying signet-ring cell features, others showing poorly differentiated neuroendocrine carcinoma changes, and some cells exhibiting plasmacytoid characteristics. In one patient, tumor cells were arranged in nests, with relatively uniform cell sizes and a palisaded pattern at the periphery. Another patient exhibited most tumor cells arranged in glandular structures with minimal mucin in the cytoplasm. Epithelial markers were positive in all patients. All tumor cells tested positive for AB-PAS staining in the cytoplasm. At least one neuroendocrine marker (synaptophysin, chromogranin A, CD56, insulinoma-associated protein 1) was diffusely and strongly positive in each patient. The expression of mismatch repair proteins (MLH1, MSH2, MSH6, PMS2) and RB protein at immunohistochemistry was retained in all samples. <i>Conclusion.</i> Gastrointestinal amphicrine carcinoma is rare and exhibits distinct histological and immunophenotypic features. The combination of histological morphology, immunophenotype, and AB-PAS special staining is crucial for both the diagnosis and differential diagnosis of this tumor.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"10668969251333111"},"PeriodicalIF":0.9000,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Gastrointestinal Amphicrine Carcinoma: A Clinicopathologic Study of Five Patients.\",\"authors\":\"Hairen Chen, Jinping Chen, Rong Ge\",\"doi\":\"10.1177/10668969251333111\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><i>Objective.</i> To investigate the clinicopathological features, immunophenotype, diagnosis, differential diagnosis, and prognosis of amphicrine carcinoma (AC), a rare tumor characterized by dual differentiation between adenocarcinoma and neuroendocrine carcinoma. <i>Methods.</i> The clinicopathological data of five patients with AC diagnosed by pathology at Ningbo Clinical Pathology Diagnosis Center between 2020 and 2024 were collected. These specimens were analyzed using light microscopy, special staining, and immunohistochemical staining. Relevant literature was also reviewed. <i>Results.</i> The study included four men and one woman (range: 21-80 years) with gastric (3) and colorectal neoplasms (2). In all patients, tumor cells exhibited infiltrative growth, involving the subserosal or the serosal layer. Three tumors showed diffuse growth, with some cells displaying signet-ring cell features, others showing poorly differentiated neuroendocrine carcinoma changes, and some cells exhibiting plasmacytoid characteristics. In one patient, tumor cells were arranged in nests, with relatively uniform cell sizes and a palisaded pattern at the periphery. Another patient exhibited most tumor cells arranged in glandular structures with minimal mucin in the cytoplasm. Epithelial markers were positive in all patients. All tumor cells tested positive for AB-PAS staining in the cytoplasm. At least one neuroendocrine marker (synaptophysin, chromogranin A, CD56, insulinoma-associated protein 1) was diffusely and strongly positive in each patient. The expression of mismatch repair proteins (MLH1, MSH2, MSH6, PMS2) and RB protein at immunohistochemistry was retained in all samples. <i>Conclusion.</i> Gastrointestinal amphicrine carcinoma is rare and exhibits distinct histological and immunophenotypic features. The combination of histological morphology, immunophenotype, and AB-PAS special staining is crucial for both the diagnosis and differential diagnosis of this tumor.</p>\",\"PeriodicalId\":14416,\"journal\":{\"name\":\"International Journal of Surgical Pathology\",\"volume\":\" \",\"pages\":\"10668969251333111\"},\"PeriodicalIF\":0.9000,\"publicationDate\":\"2025-05-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Surgical Pathology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/10668969251333111\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"PATHOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Surgical Pathology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/10668969251333111","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PATHOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目标。摘要目的探讨腺癌与神经内分泌癌双重分化的罕见肿瘤两性癌的临床病理特征、免疫表型、诊断、鉴别诊断及预后。方法。收集宁波市临床病理诊断中心2020 - 2024年经病理诊断的5例AC患者的临床病理资料。使用光镜、特殊染色和免疫组织化学染色对这些标本进行分析。并对相关文献进行了综述。结果。该研究包括4名男性和1名女性(年龄范围:21-80岁),分别患有胃(3)和结直肠肿瘤(2)。在所有患者中,肿瘤细胞表现为浸润性生长,累及浆膜下或浆膜层。3例肿瘤呈弥漫性生长,部分细胞表现为印戒细胞特征,部分细胞表现为低分化的神经内分泌癌改变,部分细胞表现为浆细胞样特征。1例患者肿瘤细胞呈巢状排列,细胞大小相对均匀,周围呈栅栏状。另一位患者肿瘤细胞呈腺状排列,细胞质中粘液含量极少。所有患者的上皮标志物均为阳性。所有肿瘤细胞细胞质AB-PAS染色均呈阳性。每位患者至少有一种神经内分泌标志物(synaptophysin, chromogranin A, CD56,胰岛素瘤相关蛋白1)弥漫性且强烈阳性。免疫组化结果显示,所有样品中错配修复蛋白(MLH1、MSH2、MSH6、PMS2)和RB蛋白的表达均保持不变。结论。胃肠道两性癌是罕见的,表现出独特的组织学和免疫表型特征。结合组织形态学、免疫表型和AB-PAS特异性染色对本病的诊断和鉴别诊断至关重要。
Gastrointestinal Amphicrine Carcinoma: A Clinicopathologic Study of Five Patients.
Objective. To investigate the clinicopathological features, immunophenotype, diagnosis, differential diagnosis, and prognosis of amphicrine carcinoma (AC), a rare tumor characterized by dual differentiation between adenocarcinoma and neuroendocrine carcinoma. Methods. The clinicopathological data of five patients with AC diagnosed by pathology at Ningbo Clinical Pathology Diagnosis Center between 2020 and 2024 were collected. These specimens were analyzed using light microscopy, special staining, and immunohistochemical staining. Relevant literature was also reviewed. Results. The study included four men and one woman (range: 21-80 years) with gastric (3) and colorectal neoplasms (2). In all patients, tumor cells exhibited infiltrative growth, involving the subserosal or the serosal layer. Three tumors showed diffuse growth, with some cells displaying signet-ring cell features, others showing poorly differentiated neuroendocrine carcinoma changes, and some cells exhibiting plasmacytoid characteristics. In one patient, tumor cells were arranged in nests, with relatively uniform cell sizes and a palisaded pattern at the periphery. Another patient exhibited most tumor cells arranged in glandular structures with minimal mucin in the cytoplasm. Epithelial markers were positive in all patients. All tumor cells tested positive for AB-PAS staining in the cytoplasm. At least one neuroendocrine marker (synaptophysin, chromogranin A, CD56, insulinoma-associated protein 1) was diffusely and strongly positive in each patient. The expression of mismatch repair proteins (MLH1, MSH2, MSH6, PMS2) and RB protein at immunohistochemistry was retained in all samples. Conclusion. Gastrointestinal amphicrine carcinoma is rare and exhibits distinct histological and immunophenotypic features. The combination of histological morphology, immunophenotype, and AB-PAS special staining is crucial for both the diagnosis and differential diagnosis of this tumor.
期刊介绍:
International Journal of Surgical Pathology (IJSP) is a peer-reviewed journal published eight times a year, which offers original research and observations covering all major organ systems, timely reviews of new techniques and procedures, discussions of controversies in surgical pathology, case reports, and images in pathology. This journal is a member of the Committee on Publication Ethics (COPE).