肉瘤样肝内胆管细胞癌2例误诊分析

Misdiagnosis Analysis of 2 Cases of Sarcomatoid Intrahepatic Cholangiocarcinoma

摘要: 目的：对2例肉瘤样肝内胆管细胞癌病例误诊进行分析，提高对肉瘤样肝内胆管细胞癌的病理诊断能力。方法：对本院收治的2例肉瘤样肝内胆管细胞癌误诊为上皮样血管肉瘤，进行形态学与免疫组化进行分析，探讨误诊原因。结果：肉瘤样肝内胆管细胞癌在形态学与免疫组织化学上具有上皮、间叶双向分化特点，与上皮样血管肉瘤在组织学、免疫组化有共性也不同。结论：肉瘤样肝内胆管细胞癌病理诊断容易误诊，在诊断方面需要形态学与免疫组织化学的结合，同时进行必要的网状纤维染色等进一步鉴别。

Abstract: Objective: Misdiagnosis analysis was performed on 2 cases of sarcomatoid intrahepatic cholangio-carcinoma to improve the pathological diagnosis of sarcoma-like intrahepatic bile duct cell carci-noma. Methods: Two cases of sarcomatoid intrahepatic cholangiocarcinoma admitted to our hospital were analyzed by pathological diagnosis, morphology and immunohistochemistry, and meanwhile, the differential diagnosis was analyzed with epithelioid angiosarcoma. Results: Sarcomatoid intra-hepatic cholangiocarcinoma has some morphological and immunohistochemical characteristics, which are characterized by bidirectional differentiation of epithelial mesenchymal cells, and are different from epithelioid angiosarcoma in histology and immunohistochemistry. Conclusion: The diagnosis of sarcomatoid intrahepatic cholangiocarcinoma requires the combination of morphology and immunohistochemistry, and further differentiation of epithelioid angiosarcoma in morphology, immunohistochemistry and reticular fiber staining.