Peripheral intrahepatic cholangiocarcinoma: ultrasound findings and differential diagnosis from hepatocellular carcinoma

1998 ◽  
Vol 7 (2) ◽  
pp. 93-99 ◽  
Author(s):  
Agostino Colli ◽  
Massimo Cocciolo ◽  
Nicola Mumoli ◽  
Lucia Cesarini ◽  
Aniello Prisco ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Differential Diagnosis ◽  
Intrahepatic Cholangiocarcinoma ◽  
Ultrasound Findings

Fibrolamellar Carcinoma With Predominantly Pseudoglandular Architecture: A Potential Diagnostic Pitfall

2020 ◽  
pp. 106689692093334
Author(s):  
Mariëtte du Toit ◽  
Alessandro Pietro Aldera
Keyword(s):  
Hepatocellular Carcinoma ◽  
Differential Diagnosis ◽  
Intrahepatic Cholangiocarcinoma ◽  
Systematic Approach ◽  
Metastatic Adenocarcinoma ◽  
Liver Mass ◽  
Diagnostic Pitfall ◽  
Fibrolamellar Carcinoma ◽  
Clinical Differential Diagnosis ◽  
Mass Lesions

Biopsies of liver mass lesions are encountered frequently in general surgical pathology practice. The clinical differential diagnosis is typically hepatocellular carcinoma (HCC) versus metastatic adenocarcinoma. There are a variety of HCC variants that show a range of morphological appearances. The presence of malignant glands in the liver prompts the pathologist to consider adenocarcinoma, either metastatic or primary intrahepatic cholangiocarcinoma. It is important to remember that some variant patterns of HCC can show pseudoglandular growth. In this article, we present a case of fibrolamellar carcinoma that showed predominantly pseudoglandular growth to highlight the importance of a systematic approach and the routine use of a panel of immunohistochemical stains (HepPar1, CK7, and CD68).

Differentiation between hepatocellular carcinoma and intrahepatic cholangiocarcinoma using contrast-enhanced ultrasound: A systematic review and meta-analysis

2021 ◽  
pp. 1-17
Author(s):  
Yanling Chen ◽  
Wenping Wang
Keyword(s):  
Hepatocellular Carcinoma ◽  
Diagnostic Accuracy ◽  
Publication Bias ◽  
Likelihood Ratio ◽  
Intrahepatic Cholangiocarcinoma ◽  
Cochrane Library ◽  
Arterial Phase ◽  
Contrast Enhanced Ultrasound ◽  
Diagnostic Ability ◽  
Contrast Enhanced

AIM: To explore the diagnostic ability of contrast-enhanced ultrasound (CEUS) in distinguishing intrahepatic cholangiocarcinoma (ICC) from hepatocellular carcinoma (HCC). MATERIALS AND METHODS: PubMed, EMBASE, Cochrane Library, and Web of Science were systematically searched for studies reporting the diagnostic accuracy of CEUS in differentiating ICC from HCC. The diagnostic ability of CEUS was assessed based on the pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive likelihood ratio (PLR), negative likelihood ratio (NLR) and area under the curve (AUC) with 95% confidence intervals (CIs). The methodologic quality was assessed by the QUADAS-2 tool. Subgroup analyses, meta-regression and investigation of publication bias were performed to identify the source of heterogeneity. RESULTS: A total of eight studies were included, consisting of 1,116 patients with HCC and 529 with ICC. The general diagnostic performance of CEUS in distinguishing ICC and HCC were as follows: pooled sensitivity, 0.92 (95% CI: 0.84–0.96); pooled specificity, 0.87 (95% CI: 0.79–0.92); pooled PLR, 7.1 (95% CI: 4.1–12.0); pooled NLR, 0.09 (95% CI: 0.05–0.19); pooled DOR, 76 (95% CI: 26–220) and AUC, 0.95(95% CI: 0.93–0.97). Different liver background may be a potential factor that influenced the diagnostic accuracy of CEUS according to the subgroup analysis, with the pooled DOR of 89.67 in the mixed liver background group and 46.87 in the cirrhosis group, respectively. Six informative CEUS features that may help differentiate HCC from ICC were extracted. The three CEUS features favoring HCC were arterial phase hyperenhancement(APHE), mild washout and late washout (>60s); the three CEUS favoring ICC were arterial rim enhancement, marked washout and early washout(<60s). No potential publication bias was observed. CONCLUSION: CEUS showed great diagnostic ability in differentiating ICC from HCC, which may be promising for noninvasive evaluation of these diseases.

Mixed hepatocellular cholangiocarcinoma and intrahepatic cholangiocarcinoma in patients undergoing transplantation for hepatocellular carcinoma

2011 ◽  
Vol 17 (8) ◽  
pp. 934-942 ◽  
Author(s):  
Gonzalo Sapisochin ◽  
Nicholas Fidelman ◽  
John P. Roberts ◽  
Francis Y. Yao
Keyword(s):  
Hepatocellular Carcinoma ◽  
Intrahepatic Cholangiocarcinoma

scholarly journals Adrenocortical carcinoma masquerading as pheochromocytoma: a histopathologic dilemma

2020 ◽  
Vol 2020 ◽  
Author(s):  
Impana Shetty ◽  
Sarah Fuller ◽  
Margarita Raygada ◽  
Maria J Merino ◽  
B J Thomas ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Differential Diagnosis ◽  
Lynch Syndrome ◽  
Adrenocortical Carcinoma ◽  
Renal Carcinoma ◽  
Thoracoscopic Surgery ◽  
Adrenal Adenoma ◽  
Wedge Resection ◽  
Genetic Profile ◽  
List Type

Summary Adrenocortical carcinoma (ACC) is an aggressive cancer that originates in the cortex of the adrenal gland and generally has a poor prognosis. ACC is rare but can be more commonly seen in those with cancer predisposition syndromes (e.g. Li-Fraumeni and Lynch Syndrome). The diagnosis of ACC is sometimes uncertain and it requires the use of precise molecular pathology; the differential diagnosis includes pheochromocytoma, adrenal adenoma, renal carcinoma, or hepatocellular carcinoma. We describe a case of a 57-year-old woman with Lynch Syndrome and metastatic ACC who was initially diagnosed as having pheochromocytoma. The tumor was first identified at 51 years of age by ultrasound followed by a CT scan. She underwent a left adrenalectomy, and the histopathology identified pheochromocytoma. Two years later, she had tumor recurrence with imaging studies showing multiple lung nodules. Following a wedge resection by video-assisted thoracoscopic surgery (VATS), histopathology was read as metastatic pheochromocytoma at one institution and metastatic ACC at another institution. She later presented to the National Institutes of Health (NIH) where the diagnosis of ACC was confirmed. Following her ACC diagnosis, she was treated with mitotane and pembrolizumab which were stopped due to side effects and progression of disease. She is currently receiving etoposide, doxorubicin, and cisplatin (EDP). This case highlights the importance of using a multi-disciplinary approach in patient care. Thorough evaluation of the tumor’s pathology and analysis of the patient’s genetic profile are necessary to obtain the correct diagnosis for the patient and can significantly influence the course of treatment. Learning points: Making the diagnosis of ACC can be difficult as the differential diagnosis includes pheochromocytoma, adrenal adenoma, renal carcinoma, or hepatocellular carcinoma. Patients with Lynch Syndrome should undergo surveillance for ACC as there is evidence of an association between Lynch Syndrome and ACC. Conducting a complete tumor immunoprofile and obtaining a second opinion is very important in cases of suspected ACC in order to confirm the proper diagnosis. A multi-disciplinary approach including genetic testing and a thorough evaluation of the tumor’s pathology is imperative to ensuring that the patient receives an accurate diagnosis and the appropriate treatment.

Recurrent hepatocellular carcinoma versus radiation-induced hepatic injury: differential diagnosis with MR imaging

2001 ◽  
Vol 19 (1) ◽  
pp. 41-46 ◽  
Author(s):  
Hiroaki Onaya ◽  
Yuji Itai ◽  
Tayeb Ahmadi ◽  
Hiroshi Yoshioka ◽  
Toshiyuki Okumura ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Differential Diagnosis ◽  
Mr Imaging ◽  
Hepatic Injury ◽  
Recurrent Hepatocellular Carcinoma ◽  
Radiation Induced

Malignant Transformation Arising Within Unusual and Rare Hepatic Lesions: Fibropolycystic Disease Form of Ductal Plate Malformation and Biliary Adenofibroma

2018 ◽  
Vol 26 (6) ◽  
pp. 542-550 ◽  
Author(s):  
Darren Chua ◽  
Adrian Kah Heng Chiow ◽  
Tiing Leong Ang ◽  
Lai Mun Wang
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Disease ◽  
Malignant Transformation ◽  
Intrahepatic Cholangiocarcinoma ◽  
Ductal Plate ◽  
Hepatobiliary Cancer ◽  
Ductal Plate Malformation ◽  
Biliary Adenofibroma ◽  
Hepatic Lesions

Cholangiocarcinoma is the second most common hepatobiliary cancer following hepatocellular carcinoma, and 20% to 25% are intrahepatic. We describe 2 cases of intrahepatic cholangiocarcinoma arising within unusual and rare hepatic lesions, fibropolycystic liver disease form of ductal plate malformation and biliary adenofibroma, whose association with malignancy is rarely reported in the literature.

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