Use of vessel patterns on contrast-enhanced ultrasonography using a perflubutane-based contrast agent for the differential diagnosis of regenerative nodules from early hepatocellular carcinoma or high-grade dysplastic nodules in patients with chronic liver disease

2015 ◽  
Vol 40 (7) ◽  
pp. 2372-2383 ◽  
Author(s):  
Kazushi Numata ◽  
Hiroyuki Fukuda ◽  
Hiromi Nihonmatsu ◽  
Masaaki Kondo ◽  
Akito Nozaki ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Differential Diagnosis ◽  
Liver Disease ◽  
Contrast Agent ◽  
High Grade ◽  
Early Hepatocellular Carcinoma ◽  
Dysplastic Nodules ◽  
Contrast Enhanced ◽  
Regenerative Nodules ◽  
Contrast Enhanced Ultrasonography

Stromal morphological changes and immunophenotypic features of precancerous lesions and hepatocellular carcinoma

2019 ◽  
Vol 72 (4) ◽  
pp. 295-303
Author(s):  
Dingbao Chen ◽  
Zhao Li ◽  
Weihua Zhu ◽  
Qian Cheng ◽  
Qiujing Song ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Differential Diagnosis ◽  
Morphological Changes ◽  
Precancerous Lesions ◽  
High Grade ◽  
Stromal Invasion ◽  
Ductular Reaction ◽  
Hepatocellular Carcinomas ◽  
Dysplastic Nodules ◽  
Small Hcc

AimsTo evaluate stromal histopathological features and immunostaining expression for differential diagnosis of low- and high-grade dysplastic nodules (HGDN) to early and progressed hepatocellular carcinomas (eHCC, pHCC).MaterialsWe evaluated sinusoid capillarisation (SC), solitary artery (SA), ductular reaction (DR), stromal invasion and expression of six biomarkers (GPC3, HSP70, GS, CD34, CK19, EpCAM) in a series of 97 cases.ResultsStromal morphological changes, including SC, DR and SA, exhibited significant differences in differential diagnosis. In one indicator, SC had the best sensitivity (90.00%) and accuracy (85.42%), and SA had the best specificity at 88.89 %. In combinations, SC +and SA +were favourable and optimal. The immunoreactivity of GPC3, HSP70 and GS increased significantly in line with the stepwise progression of hepatocarcinogenesis.ConclusionsStromal histopathology features are useful for diagnosing HGDN, eHCC and small HCC. The immunostaining panel of GPC3, HSP70 and GS can also be supplementary.

scholarly journals RESULTS OF IMMUNOHISTOCHEMISTRY IN THE DIFFERENTIAL DIAGNOSIS OF EARLY HEPATOCELLULAR CARCINOMA AND NODULES WITH HIGH-GRADE DYSPLASIA IN PATIENTS WITH CIRRHOSIS

2021 ◽  
Vol 58 (1) ◽  
pp. 82-86
Author(s):  
Gabriela Perdomo CORAL ◽  
Fernanda BRANCO ◽  
Rosalva MEURER ◽  
Patrícia dos Santos MARCON ◽  
Paulo Roberto Ott FONTES ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Differential Diagnosis ◽  
Low Grade ◽  
Beta Catenin ◽  
High Grade ◽  
Dysplastic Nodule ◽  
Dysplastic Nodules ◽  
Morphological Criteria ◽  
Early Hcc ◽  
Sensitivity Specificity

ABSTRACT BACKGROUND: Hepatocellular carcinoma (HCC) is the most frequent primary cancer of the liver and cirrhosis is considered a pre-malignant disease. In this context, the evolutionary sequence from low grade dysplastic nodule and high grade dysplastic nodule (HGDN) to early HCC and advanced HCC has been studied. The differential diagnosis between HGDN and early HCC is still a challenge, especially in needle biopsies OBJECTIVE: To evaluate an immunohistochemistry panel to differentiate dysplastic nodules and HCC. METHODS: Patients with cirrhosis who underwent surgical resection or liver transplantation were included. The sensitivity, specificity and accuracy for the diagnosis of neoplasia were analyzed by evaluating five markers: heat shock protein 70, glypican 3, glutamine synthetase, clathrin heavy chain and beta-catenin. P≤0.05 was considered statistically significant. RESULTS: One hundred and fifty-six nodules were included; of these, 57 were HCC, 14 HGDN, 18 low grade dysplastic nodules and 67 regenerative macronodules. Sensitivity of HCC diagnosis was 64.9% for glypican 3 and 77.2% for glutamine syntetase, while specificity was 96.0% and 96.0% respectively. When the panel of four markers was considered (excluding beta catenin), the specificity ranged from 87.9% for one positive marker to 100% for at least three markers. The best accuracy for HCC diagnosis was obtained with at least two positive markers, which was associated with a sensitivity of 82.5% and specificity of 99%. CONCLUSION: Differential diagnosis of dysplastic nodules and HCC by morphological criteria can be challenging. Immunomarkers are useful and should be used for the differential diagnosis between HCC and HGDN.

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