We examined the clinicopathologic features of 11 surgically resected hepatocellular carcinomas (HCCs) less than 3 cm in diameter with marked inflammatory cell infiltration (LHCCs). In comparison with the other 152 HCCs without such an infiltration (controls), there were no significant differences in male/female ratio, age, serum ␣-fetoprotein levels, and laboratory and imaging findings. All the 11 LHCC cases were hepatitis B surface antigen (HBsAg) negative and hepatitis C virus antibody positive. Among the 152 controls, 116 cases were also HBsAg negative and HCVAb positive and were referred to as HCV-only controls. The clinical features were not significantly different between the LHCC and the HCV-only controls. The LHCC group tended to have higher numbers of lymphocytes and monocytes in pre-and post-operative peripheral blood, but there were no significant group differences. Recurrence rate was 9.1% in the LHCC group, 47.7% in the controls and 47.5% in the HCV-only controls (P F .01). Five-year survival rate was 100% in the LHCC group, 65.1% in the controls and 68.1% in the HCV-only controls (P Ͻ .01). Histologically, remarkable inflammatory cell infiltration, mostly lymphocytic, was observed in the cancerous tissue of the LHCC group. Varying degrees of piecemeal necrosis of cancer nests produced by infiltrating lymphocytes were observed in all the 11 cases. Lymph follicle formation was also found in 10 of 11 cases (90.9%). Liver cirrhosis was associated in 6 LHCC cases (54.5%), in 117 control cases (77.0%), and in 91 HCV-only controls (78.4%). Tumor invasion into the portal vein in the vicinity of the tumor was found in 1 LHCC case (9.1%), in 54 controls (35.5%), and in 34 HCV-only controls (29.3%). Immunohistochemically, most of the infiltrating lymphocytes, other than those in the lymph follicle, were identified as T lymphocyte, and CD8 ؉ T lymphocyte was more predominant than CD4 ؉ T lymphocyte. Better prognosis of the LHCC group could attribute to the anti-tumor effect induced by cellular immunity of CD8 ؉ and CD4 ؉ T lymphocytes, and partly by humoral immunity of B cells which formed lymph follicles. (HEPATOLOGY 1998;27:407-414.)When tumor tissues are associated with tumor-infiltrating lymphocytes at a high density or with sinus histiocytosis in its regional lymph node at a high intensity, good postoperative survival rates for cancers have been reported in various organs. [1][2][3][4][5][6] As a mechanism of the good survival, involvement of anti-tumor effect via cellular immunity mainly of T lymphocyte and via humoral immunity of B lymphocyte, or of cytokines produced by the cancer cell itself, has been considered. [2][3][4][5][6][7][8][9][10][11] Meanwhile, as a result of the remarkable advance and popularization of various diagnostic imaging methods, the number of hepatocellular carcinoma (HCC) detected has been increasing and has been successfully resected. [15][16][17] Occasionally, HCCs with marked lymphocyte infiltration have been found among the resected tumors, 18-23 but their clinicopathologic ...

No abstract

Serous cystadenocarcinoma of the pancreas is a rare entity. We report a primary tumor of the pancreas in a 56-year-old woman that was histologically indistinguishable from microcystic adenoma, but which behaved in a malignant fashion. Metastatic lesions were found in the liver at the time of the initial operation. Nine years after the initial operation, new metastatic liver nodules were found, and the histologic characteristics of these lesions were quite similar to those of the pancreatic neoplasm. This is a very rare case which may support the existence of the entity, serous cystadenocarcinoma of the pancreas.

A pancreatic carcinoma, associated with elevated serum alpha-fetoprotein level, was resected from a 67-year-old man. The tumor was strongly suggested to be an acinar cell carcinoma of the pancreas, based on the histological findings of the resected specimen. The tumor measured 12 x 10 x 9 cm, and the cut surface was soft, whitish-yellow, focally necrotic, and hemorrhagic. Under a light microscope, the tumor cells were not arranged in a tubular and trabecular pattern, but rather, showed a tendency toward an acinar structure. Immunohistochemically, alpha 1-antitrypsin- and alpha 1-antichymotrypsin-positive reactions were diffusely positive in most of the tumor cells, while staining for chromogranin, neuron-specific enolase, Grimelius, glucagon, insulin, and alpha-fetoprotein was negative in the tumor cells. We report a large acinar cell carcinoma (associated with elevated serum alpha-fetoprotein level), which had been misdiagnosed as hepatocellular carcinoma preoperatively.

No abstract