The expression of arginase-1, keratin (K) 8 and K18 in combined hepatocellular-cholangiocarcinoma, subtypes with stem-cell features, intermediate-cell type

Abstract

Arg-1 and K8 were good markers to identify intermediate cells between hepatocytes and cholangiocytes. These can be useful markers for pathological diagnosis of CHC-INT, which usually has wide histological diversities, in combination with other hepatocytic and/or cholangiocytic markers.

Malic enzyme 1 is a potential marker of combined hepatocellular cholangiocarcinoma, subtype with stem‐cell features, intermediate‐cell type

“…Moreover, there was no case with a HepPar‐1 score ≥4 in INT. Similarly, in a study by Akiba et al ., which did not take into account the expression intensity of immunostaining, as few as 28.1% of INTs were HepPar‐1 positive and there are arguably not many cases where INTs showed strong expression of HepPar‐1. Our results showed that a case with a HepPar‐1 score ≥2 could be diagnosed as HCC with high sensitivity (93.3%) and high specificity (96.7%).…”

“…Akiba et al . previously demonstrated that arginase‐1 and keratin (K) 8 are useful for the pathological diagnosis of INT . However, no specific markers of INT have been established yet.…”

cHCC‐CCA: Consensus terminology for primary liver carcinomas with both hepatocytic and cholangiocytic differentation

“…At the current time, there are no published consensus guidelines for minimum amounts of HCC or iCCA to qualify for the diagnosis, either in biopsy material or in resected/explant samples. Examples have been illustrated . In regions in which the tumors seem to merge, the cellular morphology may be difficult to identify as either hepatocellular or cholangiocytic by pure H&E evaluation alone.…”

“…Examples have been illustrated. (7)(8)(9)(18)(19)(20)(21)(22) In regions in which the tumors seem to merge, the cellular morphology may be difficult to identify as either hepatocellular or cholangiocytic by pure H&E evaluation alone. Tumor cells of either hepatocytic or cholangiocytic morphologic type may contain intracytoplasmic inclusions common to hepatocytes such as Mallory-Denk bodies, steatosis, a1AT globules (even in an a1AT genotypically normal individual), fibrinogen, etc.…”

Two Surgical Cases of Combined Hepatocellular-Cholangiocarcinoma, Intermediate-Cell Subtype: Potentially Characteristic Gross Features

“…In particular, the histopathological findings of rare (ii) CHC-INT characteristically demonstrate a proliferation of relatively small and uniform carcinoma cells having intermediate features between hepatocytes and cholangiocytes, i.e., HCC and CCC, arranged in strands, solid nests, trabeculae, and/or ill-defined gland-/tubule-like structures [ 4 ]. A substantial number of interesting papers focusing especially on the histopathological and immunohistochemical features of CHC-INT were published [ 3 , 5 ]; however, within our thorough investigation, there has been no detailed description regarding the gross findings reported in the English literature. Indeed, the above WHO classification has merely stated that the gross morphology of CHC-INT is not significantly different from that of HCC [ 4 ]; however, we cannot completely agree with that description.…”