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目的:分析胆囊小细胞癌的形态学和免疫组化特征。方法:对3例胆囊小细胞癌组织进行临床病理和免疫组化分析,并结合文献讨论其诊断及鉴别诊断。结果:3例胆囊小细胞癌患者均为中老年女性,年龄分别为62、75、42岁,其临床表现均为餐后右上腹钝痛。例1属胆囊单纯型小细胞癌,病理检查提示为小圆细胞肿瘤浸润肌层伴明显坏死,肿瘤细胞排列紧密,呈实性片块状、灶性巢状、束状排列;高倍镜下细胞核呈圆形、卵圆形,染色质细颗粒状,胞质稀少,有时可见“Azzopardi效应”。例2、例3肿瘤组织镜下呈实性或小梁状排列,细胞呈燕麦状或短梭形,部分区域伴有低分化腺癌和印戒细胞癌,属于胆囊混合型小细胞癌。免疫组化染色显示肿瘤细胞表达上皮及神经内分泌双重标志。结论:胆囊小细胞癌非常罕见,根据组织学特征和免疫组化染色结果可与其他小圆细胞肿瘤相鉴别。
Objective: To analyze the morphological and immunohistochemical features of small cell carcinoma of gallbladder. Methods: Three cases of gallbladder SCC were analyzed by clinicopathological and immunohistochemical methods, and their diagnosis and differential diagnosis were discussed in combination with the literature. Results: All the 3 patients with gallbladder small cell carcinoma were middle-aged and old women, with the ages of 62, 75 and 42 respectively. The clinical manifestations were dull pain of right upper quadrant after meal. Example 1 is a simple small cell carcinoma of the gallbladder, the pathological examination showed small infiltrating myometrial tumor with obvious necrosis, the tumor cells arranged closely, was solid piece, fissure nests, bundles arrangement; high magnification nucleus Round, oval, fine chromatin, cytoplasmic sparse, sometimes visible “Azzopardi effect ”. Example 2, Example 3 Tumor microscopy showed a solid or trabecular arrangement of cells was oval or short fusiform, with some poorly differentiated adenocarcinoma and signet-ring cell carcinoma, belonging to gallbladder mixed small cell carcinoma. Immunohistochemical staining showed that the tumor cells expressed double markers of epithelial and neuroendocrine. Conclusions: Small cell carcinoma of the gallbladder is very rare and distinguishes with other small round cell tumors based on histological features and immunohistochemical staining.