96. Jahrestagung der Deutschen Gesellschaft für Pathologie e. V ...

Abstracts
FR-P-101
Metachronic coincidence of a neuroendocrine carcinoma of the
gall bladder after former endometrioid ovarian adenocarcinoma
M . Petersen 1 , T . Kalinski 2 , H . Lippert 1 , J . Bischoff 3 , U .R . Bohr 4 , F . Meyer 1
1 University Hospital, Dept . of Surgery, Magdeburg, 2 University Hospital, Institute
of Pathology, Magdeburg, 3 University Hospital, Dept . of Gynecology
& Obstetrics, Magdeburg, 4 University Hospital, Dept . of Gastroenterology,
Hepatology & Infectious Diseases, Magdeburg
Aims. Along the demographic development, there is an increasing agedependent
multimorbidity. In particular, tumor diseases and second
malignancies will have an impact on the future profile of medical care.
Simultaneous or subsequent (within a short-term interval) occurrence
of two tumor manifestations is always a clinical challenge, especially
with regard to finding the correct diagnosis clarifying malignancy of the
same or different entity.
Methods. By means of an extraordinary and exemplary case report, the
challenge is demonstrated to precisely diagnose a tumor lesion based on
available results of investigations and to differentiate between recurrent
tumor growth and a metastasized tumor manifestation of a second (different)
tumor lesion.
Results. Medical history and clinical finding: In a 73-year-old woman,
histopathological investigation of a specimen after cholecystectomy revealed
a slightly differentiated adenocarcinoma including a lymph node
metastasis. To exclude a metastasis of a known endometrioid ovarian
adenocarcinoma, comparing immunhistological investigations resulted
in: i) CK7-/CA125-negative, CK20-/chromogranin-A-/synaptophysinpositive
(counting for gall bladder and lymph node metastasis); ii) CK7-/
CA125-positive, CK20-/Chromogranin-A-/synaptophysin-negative
(counting for ovar). Therefore, tumor lesion of the gall bladder and the
lymph node was rather associated with a neuroendocrine carcinoma of
the gall bladder than with a metastasis of an ovarian carcinoma. Based
on the diagnosis, re-laparotomy was performed including resection of
the cystic stump and atypical resection of hepatic segment V (“liver bed”
of the gall bladder) as well as lymph node dissection of the hepatoduodenal
ligament. Clinical course: After 14 months, a further metastasis
of a neuroendocrine carcinoma within an additional lymph node was
diagnosed. There had been no recurrent tumor growth of the left-sided
endometrioid ovarian adenocarcinoma since 8 years.
Conclusions. Due to the increased incidence of tumor diseases and second
neoplasias, histopathological and immunohistochemical analyses
are very important in the diagnostic process. According to the available
literature, the presented case is the first description of a metachronous
coincidence of an endometrioid ovarian adenocarcinoma and a neuroendocrine
carcinoma of the gall bladder.
FR-P-102
No crush artifacts: statistical analysis of the histological changes
in the donor bile ducts with special regard to ischemic-type
biliary lesion (ITBL)
T . Hansen1 , D . Hollemann1 , M . Heise2 , M . Hoppe-Lotichius2 , C .J . Kirkpatrick1 ,
G . Otto2 1 2 University of Mainz, Institute of Pathology, Mainz, University of Mainz,
Department of Transplantation/Hepatobiliopancreatic Surgery, Mainz
Aims. Ischemic-type biliary lesion (ITBL) is a feared complication after
liver transplantation as it often leads to graft loss. Recently, we presented
the histological changes of the donor bile ducts taken during liver
transplantation. We now performed a scoring system and statistically
analysed the results. With special reference to ITBL, significant findings
are now demonstrated.
Methods. The histomorphology of the donor bile ducts was studied
84 patients (recipients: 68 male, 16 female, median age 58 yrs; donors:
40 male, 44 female; median age 52.5 yrs). For the characteristic histological
findings, a histological scoring system was established. The single
116 | Der Pathologe · Supplement 1 · 2012
phenomena and the sum score were then statistically reviewed with regard
to the development of ITBL. χ2-test was used to compare the different
score values; p0.001). Correlation of DMBT1 expression with age identified
significant higher expression in older patients (p>0.001).
Conclusions. Our data suggest that DMBT1 seems to play a diverse role
in chronic inflammation of bile ducts and in the development of BTC
dependent on spatiotemporal expression. DMBT1 expression might be of
importance in the progression of BTC and ultimately have an influence
on the outcome of BTC-patients.