Fetal gut–like differentiation in gallbladder cancer

Koyama, Kei; Maeda, Daichi; Tamura, Daisuke; Narita, Chisato; Kudo-Asabe, Yukitsugu; Sato, Tsutomu; Yamamoto, Yūzō; Sato, Masato; Nanjo, Hiroshi; Goto, Akiteru

doi:10.1016/j.humpath.2017.09.009

Cited by 7 publications

(7 citation statements)

References 26 publications

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“…Gastric HPC/RT is reported to exhibit aggressive biological behavior due to vascular invasion, lymph node metastasis, and liver metastasis, and has a poor prognosis 2,12,17,18 . To the best of our knowledge, HPC/RT cases of the biliary tract have been reported in 13 cases of gallbladder cancer, 19–24 four cases of eCCA, 8–11 and four cases of ampullary cancer 25–28 . HPCs/RTs of the gallbladder have been reported mostly as case reports, 20–22,24,29–34 and only two case studies.…”

Section: Discussionmentioning

confidence: 99%

“…One study showed that one AFP‐positive HPC/RT was found among histologically ten clear cell carcinomas selected from >550 cases of gallbladder carcinomas 23 . The other study showed that one SALL4‐positive and AFP‐positive HPC/RT was detected in 49 cases of gallbladder carcinomas 19 . From these reports, no particular clinicopathological characteristics of HPC/RT in the gallbladder have been offered, except for general histopathological features of HPC/RT.…”

Section: Discussionmentioning

confidence: 99%

“…23 The other study showed that one SALL4-positive and AFP-positive HPC/RT was detected in 49 cases of gallbladder carcinomas. 19 From these reports, no particular clinicopathological characteristics of HPC/RT in the gallbladder have been offered, except for general histopathological features of HPC/RT. In four HPC/RT cases of the ampulla of Vater that all have been reported as case reports, [25][26][27] they are histologically solid type carcinoma and/or welldifferentiated papillary and tubular adenocarcinomas.…”

Section: Discussionmentioning

confidence: 99%

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Hepatoid carcinoma and related entities of the extrahepatic bile duct: A clinicopathological study of four cases

Okura¹,

Esaki²,

Nara³

et al. 2022

Pathology International

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Hepatoid carcinoma or related entities (HPC/RTs) are extremely rare, especially in the extrahepatic bile duct (EHBD). Only a few case reports have been published. We analyzed the clinicopathological features of HPCs/RTs in EHBD. HPC/RT of extrahepatic cholangiocarcinoma (eCCA) cases were selected based on the histological characteristics and immunohistochemical detection of spalt-like transcription factor 4 (SALL4) and/or alpha-fetoprotein (AFP). Four HPC/RT cases arose in the distal but not in the perihilar EHBD. The four patients with HPC/RT included one female and three males with a median age of 77 years. There are various macroscopic types of HPC/RT. The predominant histological features were two solid-type carcinomas that mimicked hepatocellular carcinoma and two well-differentiated tubular adenocarcinomas. Immunohistochemically, SALL4 and glypican-3 were expressed in all cases, and AFP was expressed in one case. Cancer cell phenotypes included intestinal, pancreatobiliary, and mixed pancreatobiliary and intestinal types. Focal neuroendocrine differentiation and severe perineural and lymphovascular invasions were also observed. HPC/RT recurred in two patients within 2 years, and one patient died 13 months postoperatively. It is suggested that the HPC/RT of EHBD shares common characteristics with HPC/RT arising in various organs, and has some unique characteristics. HPC/RT of EHBD might be more aggressive than conventional eCCA.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Hepatoid carcinoma and related entities of the extrahepatic bile duct: A clinicopathological study of four cases

Okura¹,

Esaki²,

Nara³

et al. 2022

Pathology International

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“…196 Because SALL4 regulates pluripotency, SALL4 can be expressed in immature or fetal-type tissues such as fetallike differentiation in gallbladder, duodenal, gastric, and lung ACAs (59%). [198][199][200] SALL4 is also expressed in blastemal tumors, such as the embryonal component of hepatoblastoma (58%) and Wilms tumor (50%). 180,181 In recent years, SALL4 is increasingly used in the diagnosis of SMARCB1/INI1-deficient tumors.…”

Section: Organic Cation Transportermentioning

confidence: 99%

Practical Application of Lineage-Specific Immunohistochemistry Markers: Transcription Factors (Sometimes) Behaving Badly

Kei

Adeyi

2019

Archives of Pathology &Amp; Laboratory Medicine

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Context.— Transcription factors (TFs) are proteins that regulate gene expression and control RNA transcription from DNA. Lineage-specific TFs have increasingly been used by pathologists to determine tumor lineage, especially in the setting of metastatic tumors of unknown primary, among other uses. With experience gathered from its daily application and increasing pitfalls reported from immunohistochemical studies, these often-touted highly specific TFs are not as reliable as once thought. Objectives.— To summarize the established roles of many of the commonly used TFs in clinical practice and to discuss known and potential sources for error (eg, false-positivity from cross-reactivity, aberrant, and overlap “lineage-specific” expression) in their application and interpretation. Data Sources.— Literature review and the authors' personal practice experience were used. Several examples selected from the University Health Network (Toronto, Ontario, Canada) are illustrated. Conclusions.— The application of TF diagnostic immunohistochemistry has enabled pathologists to better assess the lineage/origin of primary and metastatic tumors. However, the awareness of potential pitfalls is essential to avoid misdiagnosis.

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“…Adenocarcinoma with enteroblastic differentiation (AEBD), also called fetal gut-like adenocarcinoma (3,4), was listed as a variant of gastric adenocarcinoma in the World Health Organization (WHO) classification of the digestive system. At present, AEBD is confined to the digestive system, including the colorectum (5), ampulla of Vater (6), duodenum (7), and gallbladder (8). AEBD outside the digestive system was not well revealed, especially in the female reproductive system.…”

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confidence: 99%

Yolk Sac Tumor Originating From Cervical Adenocarcinoma: A Case Predominated by Enteroblastic Differentiation

Liu

Xiao

et al. 2022

International Journal of Gynecological Pathology

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The fetal gut-like phenotype can be found in yolk sac tumors and adenocarcinomas with enteroblastic differentiation (AEBDs). We report a cervical yolk sac tumor in a 44-yr-old woman. The tumor has similar morphology, immunophenotype, and molecular features to the AEBD of the digestive system. The tumor showed a glandular-predominant growth pattern, composed of columnar cells with clear glycogen-rich cytoplasm. The microcystic/reticular architecture or Schiller-Duval bodies were not found in the tumor. Immunohistochemically, the tumor cells were positive for p16, glypican-3 (GPC3), spalt-like transcription factor 4 (SALL4), CDX-2, and p53. TP53 mutation was identified by next-generation sequencing, and human papillomavirus (HPV) 35 was detected by HPV DNA polymerase chain reaction. In the present case, the adenocarcinoma cells in the superficial cervical glandular epithelium and the nonclear glandular components proved the existence of somatic components. The positivity of p16 and HPV also supports that the present case originates from an HPV-associated adenocarcinoma. The yolk sac tumor should be thought of as “germ cell differentiation” from a somatic carcinoma. This kind of yolk sac tumor arising from somatic-type adenocarcinoma in the female genital tract may be the counterpart of AEBD in the digestive tracts and adenocarcinomas with fetal gut-like morphology in other organs. The tumor might be more aggressive than conventional adenocarcinoma, pathologists should highlight the existence of the enteroblastic component in the pathologic report.

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Fetal gut–like differentiation in gallbladder cancer

Cited by 7 publications

References 26 publications

Hepatoid carcinoma and related entities of the extrahepatic bile duct: A clinicopathological study of four cases

Hepatoid carcinoma and related entities of the extrahepatic bile duct: A clinicopathological study of four cases

Practical Application of Lineage-Specific Immunohistochemistry Markers: Transcription Factors (Sometimes) Behaving Badly

Yolk Sac Tumor Originating From Cervical Adenocarcinoma: A Case Predominated by Enteroblastic Differentiation

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