Clinicopathologic study of 10 cases of gastric adenocarcinoma with hepatoid or enteroblastic differentiation

Abstract

Gastric adenocarcinoma with hepatoid or enteroblastic differentiation (GAHED), known also as AFP-producing carcinoma, is a rare neoplasm. Ten cases with GA-HED and 209 cases without GAHED were selected. Clinicopathological features of GAHED were investigated. The disease-free survival (DFS) of the GAHED group was compared with that of the non-GAHED group. Grossly, the tumours consisted of two early types and eight advanced types. Histologically, all tumours were composed of various proportions of tubular, cribriform, papillary, solid, and/or trabecular growth patterns of clear to slightly eosinophilic tumour cells. Hyaline globules were observed in all tumours. AFP and Hep-Par1 were immunoreactive in all tumours. In fluorescence in situ hybridisation of HER2 gene/chromosome 17, the amplification of HER2 gene was observed in two cases that showed positive reaction for HER2 protein. Clinical follow-up was available in nine cases. Regarding the clinical outcome, 3 and 6 patients were alive without disease and alive with disease, respectively. In a statistical analysis, the DFS of the GAHED group was significantly worse than that of the non-GAHED group. GAHED is morphologically characterised by various growth patterns of clear to slightly eosinophilic tumour cells and intracytoplasmic possession of hyaline globules. This tumour may have the potential to behave in an aggressive clinical fashion.

Pitfalls in the diagnosis of yolk sac tumor: Lessons from a clinical trial

“…The presented case histologically resembles AFP‐secreting gastric adenocarcinoma with enteroblastic differentiation that mimics primitive intestinal epithelium. NGS demonstrating increased copies of ERBB2 supports the diagnosis; it has also been identified as the most frequently amplified gene in gastric adenocarcinoma with enteroblastic differentiation 21,44–46 . On the other hand, ERBB2 amplification has not been described in GCTs.…”

Gastric Adenocarcinoma with Enteroblastic Differentiation in the Presence of Calcification: A Case Report and Review of the Literature

“…However, compared to traditional gastric adenocarcinoma, gastric adenocarcinoma with enteroblastic differentiation is more likely to invade into lymphatic vessels and vascular lumen, and to metastasize to the liver and lymph nodes. 2,3 Morphologically, gastric adenocarcinoma with enteroblastic differentiation grows in a tubular or papillary pattern, characterized by cuboidal or columnar cells, with transparent cytoplasm and nuclei located at the base, similar to the morphology of early fetal intestinal epithelium. 4,5 Immunohistochemically, gastric adenocarcinoma with enteroblastic differentiation expresses at least one marker of the intestinal progenitor cell lineage (AFP, glypican-3, SALL4), with glypican-3 being the most sensitive.…”

Hepatoid adenocarcinoma of the stomach: CT findings

“…In HAS, LN metastatic lesions are larger and more susceptible to necrosis, and enhancement levels are higher in metastatic lesions than in primary lesions (9). HAS has a strong local invasion property and shows a strong tendency of hepatic metastasis and venous invasion (3,14,16). In gastric adenocarcinoma, the hepatic metastasis rate at diagnosis is 2.5% (1), while, in this study on HAS, the hepatic metastasis rate at diagnosis was 63.6% (14/22).…”