Advertisement

Virchows Archiv

, Volume 449, Issue 5, pp 585–590 | Cite as

Intrahepatic sarcomatoid cholangiocarcinoma of round cell variant: a case report and immunohistochemical studies

  • Katsuaki Sato
  • Hiroshi Murai
  • Yoshimichi Ueda
  • Shogo Katsuda
Case Report

Abstract

Sarcomatoid transformation was observed in 4.5% of autopsied cases of intrahepatic cholangiocarcinoma. Here, we report a case of intrahepatic sarcomatoid cholangiocarcinoma with round cell feature, extremely rare variant. An 87-year-old man was incidentally found to have a tumor in the left lobe of the liver by abdominal computed tomography scans. The patient was clinically diagnosed to have intrahepatic cholangiocarcinoma and received palliative care without specific treatment. He died of hepatic insufficiency 3 months after the diagnosis. The autopsied liver specimens showed a reddish gray tumor of 4.0×2.8 cm in size. Histologically, the tumor was centrally hemorrhagic and necrotic and was composed of tubular adenocarcinoma and a round cell component, which has an eccentrically located nucleus and eosinophilic cytoplasm without mucin production. Immunohistochemically, the adenocarcinoma cells expressed cytokeratin 19 and β-catenin in their cytoplasm, with E-cadherin and CD44s at the plasma membrane. In the round cells, cytokeratin 19 and vimentin was detected in their cytoplasm and CD44s at the plasma membrane. E-cadherin immunoreactivity was weakly present in their cytoplasm and β-catenin was negative. Loss or reduction of the E-cadherin and β-catenin expressions and overexpression of CD44s in the round cells are suggested to be contributed to the high propensity for lymphatic permeation and poor prognosis.

Keywords

Intrahepatic sarcomatoid cholangiocarcinoma Round cell variant E-cadherin β-catenin CD44s 

Notes

Acknowledgements

The authors thank Ms. Yumi Tsubata (Department of Pathology, Kanazawa Medical University Hospital) for immunohistochemistry and Ms. Yoshiiku Okanemasa (Department of Pathology, Kanazawa Medical University Hospital) for electron micrographs.

References

  1. 1.
    Asao T, Nakamura J, Shitara Y, Tsutsumi S, Mochiki E, Shimura T, Takenoshita S, Kuwano H (2000) Loss of standard type of CD44 expression in invaded area as a good indicator of lymph-node metastasis in colorectal carcinoma. Dis Colon Rectum 43:1250–1254PubMedCrossRefGoogle Scholar
  2. 2.
    Ashida K, Terada T, Kitamura Y, Kaibara N (1998) Expression of E-cadherin, alpha-catenin, beta-catenin, and CD44 (standard and variant isoforms) in human cholangiocarcinoma: an immunohistochemical study. Hepatology 27:974–982PubMedCrossRefGoogle Scholar
  3. 3.
    Fujita N, Yaegashi N, Ide Y, Sato S, Nakamura M, Ishiwata I, Yajima A (1994) Expression of CD44 in normal human versus tumor endometrial tissues: possible implication of reduced expression of CD44 in lymph-vascular space involvement of cancer cells. Cancer Res 54:3922–3928PubMedGoogle Scholar
  4. 4.
    Gong Y, Sun X, Huo L, Wiley EL, Rao MS (2005) Expression of cell adhesion molecules, CD44s and E-cadherin, and microvessel density in invasive micropapillary carcinoma of the breast. Histopathology 46:24–30PubMedCrossRefGoogle Scholar
  5. 5.
    Haratake J, Horie A (1991) An immunohistochemical study of sarcomatoid liver carcinomas. Cancer 68:93–97PubMedCrossRefGoogle Scholar
  6. 6.
    Haratake J, Yamada H, Horie A, Inokuma T (1992) Giant cell tumor-like cholangiocarcinoma associated with systemic cholelithiasis. Cancer 69:2444–2448PubMedCrossRefGoogle Scholar
  7. 7.
    Honda M, Enjoji M, Sakai H, Yamamoto I, Tsuneyoshi M, Nawata H (1996) Case report: intrahepatic cholangiocarcinoma with rhabdoid transformation. J Gastroenterol Hepatol 11:771–774PubMedGoogle Scholar
  8. 8.
    Imazu H, Ochiai M, Funabiki T (1995) Intrahepatic sarcomatous cholangiocarcinoma. J Gastroenterol 30:677–682PubMedCrossRefGoogle Scholar
  9. 9.
    Kaibori M, Kawaguchi Y, Yokoigawa N, Yanagida H, Takai S, Kwon AH, Uemura Y, Kamiyama Y (2003) Intrahepatic sarcomatoid cholangiocarcinoma. J Gastroenterol 38:1097–1101PubMedCrossRefGoogle Scholar
  10. 10.
    Kakizoe S, Kojiro M, Nakashima T (1987) Hepatocellular carcinoma with sarcomatous change. Clinicopathologic and immunohistochemical studies of 14 autopsy cases. Cancer 59:310–316PubMedCrossRefGoogle Scholar
  11. 11.
    Kojiro M, Sugihara S, Kakizoe S, Nakashima O, Kiyomatsu K (1989) Hepatocellular carcinoma with sarcomatous change: a special reference to the relationship with anticancer therapy. Cancer Chemother Pharmacol 23 Suppl:S4–S8PubMedCrossRefGoogle Scholar
  12. 12.
    Lim BJ, Kim KS, Lim JS, Kim MJ, Park C, Park YN (2004) Rhabdoid cholangiocarcinoma: a variant of cholangiocarcinoma with aggressive behavior. Yonsei Med J 45:543–546PubMedGoogle Scholar
  13. 13.
    Mathew J, Hines JE, Obafunwa JO, Burr AW, Toole K, Burt AD (1996) CD44 is expressed in hepatocellular carcinomas showing vascular invasion. J Pathol 179:74–79PubMedCrossRefGoogle Scholar
  14. 14.
    Matsuo S, Shinozaki T, Yamaguchi S, Takami Y, Obata S, Tsuda N, Kanematsu T (1999) Intrahepatic cholangiocarcinoma with extensive sarcomatous change: report of a case. Surg Today 29:560–563PubMedCrossRefGoogle Scholar
  15. 15.
    Nakajima T, Kubosawa H, Kondo Y, Konno A, Iwama S (1988) Combined hepatocellular-cholangiocarcinoma with variable sarcomatous transformation. Am J Clin Pathol 90:309–312PubMedGoogle Scholar
  16. 16.
    Nakajima T, Kondo Y, Miyazaki M, Okui K (1988) A histopathologic study of 102 cases of intrahepatic cholangiocarcinoma: histologic classification and modes of spreading. Hum Pathol 19:1228–1234PubMedCrossRefGoogle Scholar
  17. 17.
    Nakajima T, Tajima Y, Sugano I, Nagao K, Kondo Y, Wada K (1993) Intrahepatic cholangiocarcinoma with sarcomatous change. Clinicopathologic and immunohistochemical evaluation of seven cases. Cancer 72:1872–1877PubMedCrossRefGoogle Scholar
  18. 18.
    Papotti M, Sambataro D, Marchesa P, Negro F (1997) A combined hepatocellular/cholangiocellular carcinoma with sarcomatoid features. Liver 17:47–52PubMedGoogle Scholar
  19. 19.
    Pignatelli M, Vessey CJ (1994) Adhesion molecules: novel molecular tools in tumor pathology. Hum Pathol 25:849–856PubMedCrossRefGoogle Scholar
  20. 20.
    Sasaki M, Nakanuma Y, Nagai Y, Nonomura A (1991) Intrahepatic cholangiocarcinoma with sarcomatous transformation: an autopsy case. J Clin Gastroenterol 13:220–225PubMedCrossRefGoogle Scholar
  21. 21.
    Shimada M, Takenaka K, Rikimaru T, Hamatsu T, Yamashita Y, Kajiyama K, Taguchi K, Shirabe K, Sugimachi K (2000) Characteristics of sarcomatous cholangiocarcinoma of the liver. Hepatogastroenterology 47:956–961PubMedGoogle Scholar
  22. 22.
    Shiozaki H, Tahara H, Oka H, Miyata M, Kobayashi K, Tamura S, Iihara K, Doki Y, Hirano S, Takeichi M, Mori T (1991) Expression of immunoreactive E-cadherin adhesion molecules in human cancers. Am J Pathol 139:17–23PubMedGoogle Scholar
  23. 23.
    Sneath RJ, Mangham DC (1998) The normal structure and function of CD44 and its role in neoplasia. Mol Pathol 51:191–200PubMedCrossRefGoogle Scholar
  24. 24.
    Washington K, Telen MJ, Gottfried MR (1997) Expression of cell adhesion molecule CD44 in primary tumors of the liver: an immunohistochemical study. Liver 17:17–23PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Katsuaki Sato
    • 1
  • Hiroshi Murai
    • 2
  • Yoshimichi Ueda
    • 1
  • Shogo Katsuda
    • 1
  1. 1.Department of Pathophysiological and Experimental PathologyKanazawa Medical UniversityIshikawaJapan
  2. 2.Department of Geriatric MedicineKanazawa Medical UniversityIshikawaJapan

Personalised recommendations