Abstract
4 cases of pleomorphic carcinoma of gall bladder were morphologically and immunohistologically examined. Case 1 was 81 years old woman complaining rt-costal pain, case 2 was 86years old man complaining abdominal tumor, case 3 was 81 years old woman complaining upper abdominal pain, case 4 was 78 years old woman complaining rt-costal pain. Case 1,2 and 3had died of carcinoma, and autopsy had undergone. Case 4 was cholecystected under the diagnosis of cholecystic stone.
Microscopically, tumor cells showed pleomorphic figure without cellular cohesiveness associated with numbers of mitosis. Most tumor cells showed mononucleated and some showed so-called bizarre cell with single or multi atypical large nucleus. Moreover, foreign body type giant cells with numbers of small nucleus were seen in case 1.
Immunohistologically, most tumor cells and B i z arre cells showed positive to EMA or keratin, and also positive to vimentin antibody. Foreign body type giant cells showed negative for EMA and keratin, but focally positive to KP-1 (anti macrophage antibody) and vimentin.
These results suggest that pleomorphic carcinoma of gall bladder origi n ate from cholecystic mucosa and show sarcomatous reaction or de-epithelialization such as presence of vimentin positive cells. Furthermore, histiocytic reaction such as foreign body giant cells is considered also to be the component of pleomorphic carcinoma.
