血中PIVKA-II が高値であった肺原発hepatoid adenocarcinoma の一手術例
63 歳，男性．健診で胸部異常影を指摘され受診．胸部CT で左S1+2 に腫瘤影を認め，PET で集積を認めた．CT ガイド下肺生検で，肝細胞癌もしくは胃肝様腺癌と診断．血中AFP 濃度とPIVKA-II 濃度は，後者で上昇を認めた．原発巣検索したが，肝臓，上部消化管に所見なく，肺原発と考え，左上葉切除術施行．腫瘍は異型細胞のシート状増生を認め，肺原発hepatoid adenocarcinoma の診断を得た．現在術後5 年，再発を認めていない．...
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| Published in | 日大医学雑誌 Vol. 75; no. 1; pp. 31 - 33 |
|---|---|
| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本大学医学会
01.02.2016
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0029-0424 1884-0779 |
| DOI | 10.4264/numa.75.1_31 |
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| Abstract | 63 歳，男性．健診で胸部異常影を指摘され受診．胸部CT で左S1+2 に腫瘤影を認め，PET で集積を認めた．CT ガイド下肺生検で，肝細胞癌もしくは胃肝様腺癌と診断．血中AFP 濃度とPIVKA-II 濃度は，後者で上昇を認めた．原発巣検索したが，肝臓，上部消化管に所見なく，肺原発と考え，左上葉切除術施行．腫瘍は異型細胞のシート状増生を認め，肺原発hepatoid adenocarcinoma の診断を得た．現在術後5 年，再発を認めていない． |
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| AbstractList | 63 歳，男性．健診で胸部異常影を指摘され受診．胸部CT で左S1+2 に腫瘤影を認め，PET で集積を認めた．CT ガイド下肺生検で，肝細胞癌もしくは胃肝様腺癌と診断．血中AFP 濃度とPIVKA-II 濃度は，後者で上昇を認めた．原発巣検索したが，肝臓，上部消化管に所見なく，肺原発と考え，左上葉切除術施行．腫瘍は異型細胞のシート状増生を認め，肺原発hepatoid adenocarcinoma の診断を得た．現在術後5 年，再発を認めていない． |
| Author | 村松, 高 日暮, 亮太 石本, 真一郎 古市, 基彦 四万村, 三惠 諸岡, 宏明 塩野, 元美 竹下, 伸二 楠美, 嘉晃 |
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| References | 5) Haninger DM, Kloecker GH, Bousamra IM, et al. Hepatoid adenocarcinoma of the lung: report of five cases and review of the literature. Mod Pathol 2014; 27: 535-542. 2) Ishikura H, Kanda M, Ito M, et al. Hepatoid adenocarcinoma; a distinctive histological subtype of alpha-fetoproteinproducing lung carcinoma. Virchows Arch A Pathol Anat Histopathol 1990; 417: 73-80. 1) Ishikura H, Fukasawa Y, Ogasawara K, et al. An AFPproducing gastric carcinoma with features of hepatic differentiation: A case report. Cancer 1985; 56: 840-848. 3) Nasu M, Soma T, Fukushima H, et al. Hepatoid carcinoma of the lung with production of alpha-fetoprotein and abnormal prothrombin: an autopsy case report. Mod Pathol 1997; 10: 1054-1058. 7) Liebman HA, Furie BC, Tong MJ, et al. Des-γ-carboxy (abnormal) prothrombin as a serum marker of primary hepatocellular carcinoma. N Engl J Med 1984; 310: 1427-1431. 8) 竹並和幸，高崎 建，山本雅一，他．肝細胞癌切除例における術前alpha-fetoprotein 及びPIVKA-II 測定の臨床病理学的意義．日消外会誌2000; 33: 25-31. 4) Oshiro Y, Takeda Y, Enomoto T, et al. A resected case of metachronous liver metastasis from lung cancer producing alpha-fetoprotein (AFP) and protein induced by vitamin K absence or antagonist II (PIVKA-II). Hepatogastroenterology 2004; 51: 1144-1147. 6) Supriatna Y, Kishimoto T, Uno T, et al. Evidence for hepatocellular differentiaton in alpha-fetoprotein-negative gastric adenocarcinoma with hepatoid morphology: a study with in situ hybridisation for alubumin mRNA. Pathology 2005; 37: 211-215. |
| References_xml | – reference: 3) Nasu M, Soma T, Fukushima H, et al. Hepatoid carcinoma of the lung with production of alpha-fetoprotein and abnormal prothrombin: an autopsy case report. Mod Pathol 1997; 10: 1054-1058. – reference: 8) 竹並和幸，高崎 建，山本雅一，他．肝細胞癌切除例における術前alpha-fetoprotein 及びPIVKA-II 測定の臨床病理学的意義．日消外会誌2000; 33: 25-31. – reference: 6) Supriatna Y, Kishimoto T, Uno T, et al. Evidence for hepatocellular differentiaton in alpha-fetoprotein-negative gastric adenocarcinoma with hepatoid morphology: a study with in situ hybridisation for alubumin mRNA. Pathology 2005; 37: 211-215. – reference: 1) Ishikura H, Fukasawa Y, Ogasawara K, et al. An AFPproducing gastric carcinoma with features of hepatic differentiation: A case report. Cancer 1985; 56: 840-848. – reference: 2) Ishikura H, Kanda M, Ito M, et al. Hepatoid adenocarcinoma; a distinctive histological subtype of alpha-fetoproteinproducing lung carcinoma. Virchows Arch A Pathol Anat Histopathol 1990; 417: 73-80. – reference: 5) Haninger DM, Kloecker GH, Bousamra IM, et al. Hepatoid adenocarcinoma of the lung: report of five cases and review of the literature. Mod Pathol 2014; 27: 535-542. – reference: 4) Oshiro Y, Takeda Y, Enomoto T, et al. A resected case of metachronous liver metastasis from lung cancer producing alpha-fetoprotein (AFP) and protein induced by vitamin K absence or antagonist II (PIVKA-II). Hepatogastroenterology 2004; 51: 1144-1147. – reference: 7) Liebman HA, Furie BC, Tong MJ, et al. Des-γ-carboxy (abnormal) prothrombin as a serum marker of primary hepatocellular carcinoma. N Engl J Med 1984; 310: 1427-1431. |
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| SubjectTerms | 免疫組織化学 肺癌 腫瘍マーカー |
| Title | 血中PIVKA-II が高値であった肺原発hepatoid adenocarcinoma の一手術例 |
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