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目的探讨肝内胆管导管内嗜酸性乳头状肿瘤(IOPN)的临床病理学特征。方法总结1例发生在肝内胆管的导管内嗜酸性乳头状肿瘤的临床、病理形态及免疫组化特征,并复习相关文献。结果患者男性,43岁。腹痛寒战1个月。CT显示左侧肝内胆管内可见3 cm×3 cm大小结节。镜下肿瘤位于扩张的囊腔内,呈分支状乳头结构,乳头被覆复层嗜酸性细胞,细胞胞质丰富,嗜酸性颗粒状。免疫组化:CK8、CK18、Hep Par-1和MUC5AC(+),CK7、CK20、MUC1和MUC2(-);Ki-67增殖指数为25%。结论肝原发性导管内嗜酸性乳头状肿瘤为罕见肿瘤,以男性患者居多,肿瘤一般体积较大(平均最大径12 cm),非浸润型完整切除后、可长期生存,而浸润型整体预后差。
Objective To investigate the clinicopathological features of intrahepatic ductal eosinophilic papillary tumors (IOPN). Methods One case of intrahepatic ductal eosinophilic papillary tumors in the intrahepatic bile duct was reviewed. The clinical, pathological and immunohistochemical features of the eosinophilic papillary tumors were reviewed. Results Patients Male, 43 years old. Abdominal pain chills 1 month. CT showed the left intrahepatic bile duct visible 3 cm × 3 cm size nodules. Microscope tumor is located in the dilated cysts, showing branched nipple structure, the nipple is coated with eosinophilic cells, cytoplasm rich, eosinophilic granular. Immunohistochemistry: CK8, CK18, Hep Par-1 and MUC5AC (+), CK7, CK20, MUC1 and MUC2 (-); Ki-67 proliferation index was 25%. Conclusions Eosinophilic papillary tumors in the primary hepatic duct are rare tumors. Most of them are male patients. The tumor volume is generally large (average maximum diameter 12 cm). After non-invasive complete resection, the tumor can survive for a long time. However, the invasive prognosis difference.