Aim The aim of this study was to investigate the expression of farnesoid X receptor ( FXR ) in human hepatocellular carcinoma ( HCC ) tissues and cell lines and evaluate its clinicopathological significance. Methods Expression levels of FXR protein and mRNA in hepatocytes, hepatic stellate cells ( SC ), and HCC cells in human liver, HCC tissues and cultured cell lines were analyzed using immunohistochemical methods, western blotting ( WB ), and quantitative reverse transcription polymerase chain reaction ( qRT – PCR ). The relationship between FXR expression and clinicopathological parameters was also investigated. Results Immunoreactivity for FXR was observed in nuclei of hepatocytes, SC and HCC cells. The intensity of nuclear FXR positive staining was comparable or increased in tumor cells of all HCC tissues when compared with hepatocytes of non‐tumorous liver tissues of the same patients as well as in comparison with metastatic colon cancers. A significant level of FXR expression in four of six human HCC cell lines was also confirmed, while it was undetectable in three cholangiocarcinoma cell lines. However, FXR protein and m RNA levels in HCC tissues determined by WB and qRT – PCR were lower than those in non‐tumorous liver tissues because of the high level of FXR expression in SC nuclei as detected by immunohistochemical double stain. Statistically significant relationships between FXR immunostaining intensity and high K i‐67 labeling indices or a history of transcatheter arterial chemoembolization in HCC patients were also disclosed. Conclusion Contrary to previous reports, preserved or enhanced expression levels of nuclear FXR were detected in HCC , indicating that FXR may play significant roles in the biological behavior of HCC .
We report a case of gastrointestinal stromal tumor (GIST) of the stomach mimicking a primary tumor of the omentum minus. The tumor presented as an isolated mass in the omentum minus without any adhesion to the stomach. Microscopic examination revealed that the tumor pseudocapsule on the gastric side included a small smooth muscle tissue component. The patient was given a diagnosis of a gastric GIST that showed extensive extramural growth. GISTs should not be defined by the localization of the tumor.
We report a case of gastrointestinal stromal tumor (GIST) of the stomach mimicking extragastrointestinal origin. The tumor presented as a large isolated mass in the transverse mesocolon with a minor adhesion to the stomach. Microscopic examination revealed c‐kit gene protein product (KIT)‐positive tumor cells with epithelioid features. The tumor pseudocapsule close to the adhesion site included a small smooth muscle tissue component, indicating a gastric origin. Furthermore, tumor cells at the adhesion site showed prominent hyalinization and calcification. The tumor was diagnosed as a gastric GIST showing extensive extramural growth. Thus, GIST of the stomach and other parts of the gastrointestinal tract can present as tumors localized in the soft tissues of the abdomen mimicking extragastrointestinal origin.
We report a case of sarcomatoid carcinoma with components of small cell carcinoma and undifferentiated carcinoma of the gallbladder. An 84‐year‐old woman was admitted to our university hospital with right upper abdominal pain and back pain. Clinical diagnosis of a gallbladder tumor was made based on the findings of abdominal ultrasonography, computed tomography and endoscopic retrograde cholangiopancreatography, and a cholecystectomy was carried out. On gross examination a pedunculated polypoid tumor protruded into the lumen of the gallbladder. Histologically the tumor was composed of carcinomatous and sarcomatous components; the carcinomatous component consisted mainly of small cell carcinoma and undifferentiated carcinoma. In general, the carcinomatous component of sarcomatoid carcinoma of the gallbladder consists of adenocarcinoma, and there have only been two previously reported cases in which the carcinomatous component consisted of small cell carcinoma or undifferentiated carcinoma. Because the patient's prognosis may be influenced by the peculiar carcinomatous component in such cases, it is important to accumulate case reports that clarify their clinicopathological features.
