:An autopsy case

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A 58-year-old male patient was admitted to our hospital because of general malaise, poor appetite and right hypochondriac pain. He was not icteric, but the liver was palpable 5 finger breadth on midline.<BR>Alphafetoprotein (AFP) and carcinoembryonic antigen (CEA) were 421ng/m/, 43.7ng/ml, respectively. CT scanning revealed many different sizes of low density areas with vague margin in both lobes of the liver. The diagnosis was primary carcinoma of the liver, but the distinction between hepatocellular and cholangiocellular carcinoma could not be made. On the 35th hospital day, he died of disseminated intravascular coagulation syndrome and acute renal failure.<BR>In autopsy findings, the liver weighing 3470g, showed a diffuse hard swelling with scattered necrotic and hemorrhagic lesions. Microscopically, the tumor was cholangiocellular carcinoma which was characterized by tubular, partially papillotubular adenocarcinoma with mucin production and rich fibrous stroma. Besides, by the immunoperoxidase stain (PAP method), AFP or CEA activity was detected in some carcinoma cells.<BR>Therefore, the positive results of AFP and CEA in the serum of the present case were probably due to the production in carcinoma cells.
社団法人日本肝臓学会の論文