A macroregenerative nodule containing multiple foci of hepatocellular carcinoma in a noncirrhotic liver

Theise, N

doi:10.1016/0270-9139(93)90112-z

Cited by 9 publications

(11 citation statements)

References 3 publications

(3 reference statements)

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“…After evaluation of entire cases, 1–2 representative tumor blocks/case were chosen that showed the least amount of necrosis and/or hemorrhage, and that included background liver for immunohistochemistry. Tumor classification was based on 2010 World Health Organization, 19 and combined hepatocellular carcinoma -cholangiocarcinoma cases were excluded from the study. Fibrosis staging (0–4) was determined using Scheuer criteria 20 .…”

Section: Methodsmentioning

confidence: 99%

Noncirrhotic hepatocellular carcinoma: derivation from hepatocellular adenoma? Clinicopathologic analysis

et al. 2014

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The majority of hepatocellular carcinomas arise in background chronic liver disease, particularly cirrhosis. The pathogenesis of non-cirrhotic hepatocellular carcinomas remains unclear. While malignant transformation reportedly occurs in <15% of hepatocellular adenoma, the prevalence of noncirrhotic hepatocellular carcinomas arising from a pre-existing adenoma is a challenge to study. Cirrhotic hepatocellular carcinoma and hepatocellular adenoma may be subclassified by molecular pathways, but little is known in noncirrhotic hepatocellular carcinoma. We aim to delineate clinical, morphologic and immunohistochemical features of noncirrhotic hepatocellular carcinoma to evaluate for possible derivation from hepatocellular adenoma. We evaluated the clinicopathologic features of 74 noncirrhotic hepatocellular carcinomas from 72 patients for underlying clinical conditions and immunohistochemical markers known to be associated with hepatocellular adenoma. Men were more commonly affected (59%); however, in the < 50 year old group, women predominated (8:1). The age range was wide: 18year – 83year; median 64year. Underlying liver diseases were identified in only 7%; however 25% had diabetes mellitus, 69% were overweight or obese, and 58% had metabolic syndrome. Only 50% of the noncirrhotic hepatocellular carcinoma were encapsulated. As published in hepatocellular adenoma, multifocality and larger tumor size were more common in liver fatty acid binding protein-negative noncirrhotic hepatocellular carcinoma. Beta-catenin nuclear positivity was uncommon (5%), and was restricted to hepatocellular carcinomas in older men. Serum amyloid A positivity was not restricted to any subtype. In summary, we present the largest series to date examining noncirrhotic hepatocellular carcinoma. We evaluated these with current hepatocellular adenoma subclassification markers for possible associations. Thirty percent of the 74 noncirrhotic hepatocellular carcinoma had some clinical, morphological or immunophenotypical associations currently described in hepatocellular adenoma. Our data also confirm the association of noncirrhotic hepatocellular carcinoma in middle aged to elderly men, an association with metabolic syndrome, and, as with hepatocellular adenoma, that women predominated in the noncirrhotic hepatocellular carcinoma subjects < 50 years of age.

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Section: Methodsmentioning

confidence: 99%

Noncirrhotic hepatocellular carcinoma: derivation from hepatocellular adenoma? Clinicopathologic analysis

et al. 2014

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“…11 The HCCs were graded as per the WHO grading system into well differentiated, moderately differentiated, or poorly differentiated. 2 …”

Section: Case Selection and Histologic Reviewmentioning

confidence: 97%

“…1 In the 2010 World Health Organization (WHO) classification, hepatic adenomas are classified into 4 subtypes: hepatocyte nuclear factor 1 alpha (HNF1a) inactivated, inflammatory, b-catenin activated, and unclassified. 2 The WHO hepatic adenoma classification is achieved in most cases by using an immunostain panel composed of liver fatty acid-binding protein (LFABP), serum amyloid A (SAA) protein, C-reactive protein (CRP), b-catenin, and glutamine synthetase (GS). The loss of LFABP is characteristic of the HNF1a-inactivated subtype, whereas the expression of SAA protein and/or CRP defines the inflammatory subtype.…”

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confidence: 99%

Immunostains Used to Subtype Hepatic Adenomas Do Not Distinguish Hepatic Adenomas From Hepatocellular Carcinomas

Liu

Shah

Naini

et al. 2016

American Journal of Surgical Pathology

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Immunostains are used to subtype hepatic adenomas to stratify for the risk of malignant transformation. The most common panel of immunostains used for this purpose includes liver fatty acid-binding protein (LFABP), serum amyloid A (SAA) protein, C-reactive protein (CRP), and glutamine synthetase (GS). Importantly, some pathologists use these stains in an attempt to distinguish hepatocellular carcinomas (HCC) from hepatic adenomas. However, there are limited data on the performance of these stains in HCCs. To investigate the staining characteristics of HCCs, we studied 159 HCCs (92 well-differentiated, 67 moderately differentiated, and 7 poorly differentiated) and 7 fibrolamellar carcinomas for the expression of LFABP, SAA, CRP, and GS. All of the stains were positive in at least a subset of HCCs: SAA was positive in 27 of 159 (17%), CRP in 86 of 159 (54%), and GS in 23 of 47 (49%) cases; LFABP showed loss of staining in 36 of 159 (23%) cases. Fibrolamellar carcinomas were consistently CRP positive (7 of 7 cases) and frequently showed loss of LFABP (4 of 7 cases). There was no association between expression of SAA, CRP, and GS as well as loss of LFABP expression and other clinicopathologic features. HCCs with loss of LFABP were more frequently associated with negative GS expression (11 of 14 cases, P=0.02). These data show that immunostains used to subtype hepatic adenomas are not useful for distinguishing HCCs from hepatic adenomas and should be used only after a diagnosis of hepatic adenoma has been made using other criteria.

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“…10). A minor degree (stage) of fibrosis in areas devoid of iron could be a direct consequence of iron loss (less toxicity) and/or related to the malignant process [16,17] in its early phase (as denoted by absence of cellular disorganization, and negativity of the MIB-1 immunostaining). It was concluded that this patient needs a strict surveillance because he may be at risk of recurrence.…”

Section: Discussionmentioning

confidence: 99%

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et al. 2005

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A macroregenerative nodule containing multiple foci of hepatocellular carcinoma in a noncirrhotic liver

Cited by 9 publications

References 3 publications

Noncirrhotic hepatocellular carcinoma: derivation from hepatocellular adenoma? Clinicopathologic analysis

Noncirrhotic hepatocellular carcinoma: derivation from hepatocellular adenoma? Clinicopathologic analysis

Immunostains Used to Subtype Hepatic Adenomas Do Not Distinguish Hepatic Adenomas From Hepatocellular Carcinomas

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