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目的探讨肝原发性破骨细胞样巨细胞瘤(OGCT)的组织学来源、临床病理特征及生物学行为。方法对1例肝原发性OGCT的大体、组织学特征、免疫组化进行观察并复习相关文献。结果患者女性,41岁。右上腹痛1周。巨检:肿物大小8 cm×4.5 cm×3 cm,部分突出肝被膜;切面灰红色、质韧,部分出血、坏死及囊性变。镜检:肿物由大量的单核间质细胞及破骨细胞样巨细胞组成,出血、坏死较多。免疫组化:单核间质细胞及破骨细胞样巨细胞CD68和vimentin(+),而CK7、SMA、CK19、CK18、EMA、溶菌酶、Hep Par-1、AFP、CK20和CD34均(-),Ki-67增殖指数15%。结论肝原发性OGCT是一种非常罕见的肿瘤,其诊断和生物学行为应该结合临床病理特征、免疫组化及是否有转移等综合因素,首先要排除转移性肿瘤。
Objective To investigate the histological origin, clinicopathological characteristics and biological behavior of primary osteoclastic giant cell tumor of liver (OGCT). Methods The gross, histological features and immunohistochemistry of primary liver OGCT in one patient were observed and reviewed. Results Female patient, 41 years old. Right upper quadrant pain for 1 week. Large examination: the size of the tumor 8 cm × 4.5 cm × 3 cm, part of the prominent liver capsule; cut gray red, quality and toughness, some bleeding, necrosis and cystic degeneration. Microscopic examination: tumor from a large number of mononuclear stromal cells and osteoclast-like giant cells, bleeding, necrosis more. Immunohistochemistry showed that CD68 and vimentin (+) of mononuclear stromal cells and osteoclast-like macrophages, and CK7, SMA, CK19, CK18, EMA, lysozyme, Hep Par-1, AFP, ), Ki-67 proliferation index of 15%. Conclusion The primary OGCT of liver is a very rare tumor. Its diagnosis and biological behavior should be combined with clinicopathological features, immunohistochemistry and whether there is metastasis and so on. First of all, to exclude metastatic tumors.