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Hepatocellular carcinoma arising in adenoma: similar immunohistochemical and cytogenetic features in adenoma and hepatocellular carcinoma portions of the tumor.
- Source :
-
Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc [Mod Pathol] 2014 Nov; Vol. 27 (11), pp. 1499-1509. Date of Electronic Publication: 2014 Apr 18. - Publication Year :
- 2014
-
Abstract
- Well-differentiated hepatocellular carcinoma in non-cirrhotic liver can show morphological features similar to hepatocellular adenoma. In rare instances, hepatocellular carcinoma can arise in the setting of hepatocellular adenoma. This study compares the immunohistochemical and cytogenetic features of the hepatocellular adenoma-like and hepatocellular carcinoma portions of these tumors. Immunohistochemistry for β-catenin, glutamine synthetase, serum amyloid A protein, glypican-3, and heat-shock protein 70 was done in 11 cases of hepatocellular carcinoma arising in hepatocellular adenoma in non-cirrhotic liver. Tumors with nuclear β-catenin and/or diffuse glutamine synthetase were considered β-catenin activated. Fluorescence in situ hybridization (FISH) was done in nine cases for gains of chromosomes 1, 8 and MYC. There were seven men (33-75 years) and four women (29-65 years). Focal atypical morphological features were seen in hepatocellular adenoma-like areas in 7 (64%) cases. Hepatocellular adenoma-like areas showed features of inflammatory hepatocellular adenoma in 7 (64%) cases; 4 of these were also serum amyloid A-positive in the hepatocellular carcinoma portion. β-Catenin activation, heat-shock protein 70 positivity, and chromosomal gains on FISH were seen in the hepatocellular adenoma portion in 55%, 40%, and 56% of cases, and 73%, 60%, and 78% of cases in the hepatocellular carcinoma portion, respectively. In conclusion, the hepatocellular adenoma-like portion of most cases of hepatocellular carcinoma arising in hepatocellular adenoma shows features typically seen in hepatocellular carcinoma such as focal morphological abnormalities, β-catenin activation, heat-shock protein 70 expression, and chromosomal gains. Hepatocellular adenoma-like areas in these tumors, especially in men and older women, may represent an extremely well-differentiated variant of hepatocellular carcinoma, whereas the morphologically recognizable hepatocellular carcinoma portion represents a relatively higher grade component of the tumor.
- Subjects :
- Adenoma, Liver Cell chemistry
Adenoma, Liver Cell genetics
Adenoma, Liver Cell pathology
Adult
Aged
Carcinoma, Hepatocellular chemistry
Carcinoma, Hepatocellular genetics
Carcinoma, Hepatocellular pathology
Cell Differentiation
Chromosomes, Human, Pair 1
Chromosomes, Human, Pair 8
Female
Glutamate-Ammonia Ligase analysis
Glypicans analysis
HSP70 Heat-Shock Proteins analysis
Humans
Liver Neoplasms chemistry
Liver Neoplasms genetics
Liver Neoplasms pathology
Male
Middle Aged
Neoplasm Grading
Neoplasms, Complex and Mixed chemistry
Neoplasms, Complex and Mixed genetics
Neoplasms, Complex and Mixed pathology
Predictive Value of Tests
Proto-Oncogene Proteins c-myc genetics
Serum Amyloid A Protein analysis
beta Catenin analysis
Adenoma, Liver Cell diagnosis
Biomarkers, Tumor analysis
Biomarkers, Tumor genetics
Carcinoma, Hepatocellular diagnosis
Immunohistochemistry
In Situ Hybridization, Fluorescence
Liver Neoplasms diagnosis
Neoplasms, Complex and Mixed diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1530-0285
- Volume :
- 27
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
- Publication Type :
- Academic Journal
- Accession number :
- 24743216
- Full Text :
- https://doi.org/10.1038/modpathol.2014.50