肝細胞癌におけるLipiodolの選択的腫瘍内停滞に関する臨床的病理形態学的研究

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Lipiodol (LPD), a lymphographic oily contrast medium, has been found to accumulate selectively in tumor, and this phenomenon has been of significance in diagnosis and treatment, particularly of hepatocellular carcinoma (HCC). In this report, we describe mainly the pathologic aspects of this selective accumulation of LPD in HCC.<BR>Eleven tumorous lesions of 8 patients operated after combination therapy of arterial injection of lipophilic anticancer drug dissolved in LPD and transcatheter arterial embolizaion (TAE) were strictly examined by x-ray CT, soft x-ray and histologic examinations of resected specimens.<BR>LPD remained selectively in blood spaces and blood capillary in tumor, and this selective accumulation was considered to depend on abnormal architecture and diameter of tumor vessels, vascularity, and underdeveloped reticuloendothelial system in tumor, in addition to physical property of viscosity of LPD. LPD-deposited area in tumor showed a trabecular type of HCC with broad blood space and massive necrosis, whereas non-LPD-deposited tumorous area showed either a scirrhous type of HCC with fibrous stroma, relatively scanty of tumor vessel, or a solid type of HCC with narrow blood spaces. Non-LPD-deposited tumorous area showed less necrotic change. The distribution of LPD in tumor was paralleled well to the degree of therapeutic effect.