Hepatoid Adenocarcinoma of the Stomach:The nature of the disease; its entity and its clinicopathology Hiroshi Ishikura 1,2 , Kazuya Mizuno 1 , Mikihiro Shamoto 3 , Koji Kirimoto 4 , Yutaka Tsukada 5 1The First Department of Pathology, Hokkaido University, School of Medicine pp.75-83
Published Date 1987/1/25
DOI https://doi.org/10.11477/mf.1403111890
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 Nine cases of primary gastric carcinomas, which had both markedly elevated serum AFP levels and foci of tumor cells with large, eosinophilic cytoplasms, were studied. They occurred in the antrum of the stomach of elder patients(Table 1). The tumors showed nodular, massive growth, and had poor prognoses because of frequent liver metastases. Histological examinations revealed that they contained medullary and/or trabecular proliferations of tumor cells, which were indistinguishable from neoplastic liver cells (Fig. 1-4). In addition, intramucosal, well-differentiated adenocarcinomas were consistently found (Fig. 5). Hepatoid and adenocarcinoma cells intermingled with each other. There were extensive venous involvements by tumor cells. Many tumor cells contained AFP, AAT, ACT, ALB, but not HCG (Fig. 8-10, 12, 15). PALB, TF, FER, PTB, and CEA were also demonstrated in some tumor cells (Table 2). There were different distributions between AFP-positive cells, and CEA-positive cells, the former being predominantly in hepatoid and the latter in adenocarcinomatous areas (Fig. 11-13). An ultrastructural study revealed that the tumor was composed of hepatoid cells, intestinal-type cells, and undifferentiated cells (Fig. 14). The patients' serum AFP could bind ConA in about 90% of the total amount. These findings suggest that the tumor cells, at least in some foci, represent true hepatocellular differentiation. Thus we propose a new clinicopathological entity, hepatoid adenocarcinoma of the stomach and show that it has a close relationship to intestinal-type adenocarcinomas both cytologically and clinically.

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