Novel immunohistochemical markers differentiate intrahepatic cholangiocarcinoma from benign bile duct lesions

2016 ◽  
Vol 69 (7) ◽  
pp. 619-626 ◽  
Author(s):  
Stefanie Bertram ◽  
Juliet Padden ◽  
Julia Kälsch ◽  
Maike Ahrens ◽  
Leona Pott ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Bile Duct ◽  
Intrahepatic Cholangiocarcinoma ◽  
Immunohistochemical Markers ◽  
Hsp 27 ◽  
Malignant Lesions ◽  
The Difference ◽  
Bile Duct Lesions ◽  
Cluster Of Differentiation ◽  
Bile Duct Adenoma

AimsThe distinction between intrahepatic cholangiocarcinoma (ICC) and benign bile duct lesions can be challenging. Using our previously identified potential biomarkers for ICC, we examined whether these are useful for the differential diagnosis of ICC, bile duct adenoma and reactive bile duct proliferations in an immunohistochemical approach and identified a diagnostic marker panel including known biomarkers.MethodsSubjects included samples from 77 patients with ICC, 33 patients with bile duct adenoma and 47 patients with ductular reactions in liver cirrhosis. Our previously identified biomarkers (stress-induced phosphoprotein 1 (STIP1), SerpinH1, 14-3-3Sigma) were tested immunohistochemically following comparison with candidates from the literature (cluster of differentiation 56, heat shock protein (HSP)27, HSP70, B-cell-lymphoma2, p53, ki67).ResultsThe expression of SerpinH1 and 14-3-3Sigma was significantly higher in ICC than in bile duct adenomas and ductular reactions (p<0.05), whereas STIP1 expression was significantly higher (p<0.05) in ICC than in ductular reactions, but the difference to the bile duct adenoma group was not significant. A panel of the biomarker SerpinH1, 14-3-3Sigma and ki67 (≥2 marker positive) showed a high diagnostic accuracy (sensitivity 87.8%, specificity 95.9%, accuracy 91.8%) in the differential diagnosis of ICC versus non-malignant bile duct lesions.ConclusionsThis suggests that 14-3-3Sigma and SerpinH1 may be useful in the differential diagnosis of malignant, benign and reactive bile duct lesions in addition to ki67 where a cut-off of >5% might be used for the distinction of malignant and non-malignant lesions.

scholarly journals What Are the Precursor and Early Lesions of Peripheral Intrahepatic Cholangiocarcinoma?

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Yasuni Nakanuma ◽  
Akemi Tsutsui ◽  
Xiang Shan Ren ◽  
Kenichi Harada ◽  
Yasunori Sato ◽  
...  
Keyword(s):  
Bile Duct ◽  
Bile Ducts ◽  
Precursor Lesions ◽  
Intraductal Papillary Neoplasm ◽  
Combined Hepatocellular Cholangiocarcinoma ◽  
Biliary Adenofibroma ◽  
Bile Duct Lesions ◽  
Large Bile Duct ◽  
Papillary Neoplasm ◽  
Bile Duct Adenoma

Cholangiocarcinoma (CC) is divided into distal, perihilar, and intrahepatic CCs (ICCS), and are further subdivided into large bile duct ICC and peripheral ICC. In distal and perihilar CC and large duct ICC, biliary intraepithelial neoplasm (BilIN) and intraductal papillary neoplasm (IPN) have been proposed as precursor lesions. Peripheral ICC, bile duct adenoma (BDA), biliary adenofibroma (BAF), and von Meyenburg complexes (VMCs) are reportedly followed by development of ICCs. Herein, we surveyed these candidate precursor lesions in the background liver of 37 cases of peripheral ICC and controls (perihilar CC, 34 cases; hepatocellular carcinoma, 34 cases and combined hepatocellular cholangiocarcinoma, 25 cases). In the background liver of peripheral ICC, BDA and BAF were not found, but there were not infrequently foci of BDA-like lesions and atypical bile duct lesions involving small bile ducts (32.4% and 10.8%, resp.). VMCs were equally found in peripheral CCs and also control CCs. In conclusion, BDA, BAF, and VMCs are a possible precursor lesion of a minority of peripheral CCs, and BDA-like lesions and atypical bile duct lesions involving small bile ducts may also be related to the development of peripheral ICC. Further pathologic studies on these lesions are warranted for analysis of development of peripheral ICCs.

scholarly journals Bile Duct Strictures Caused by Solid Masses: MR in Differential Diagnosis and as a Prognostic Tool to Plan the Endoscopic Treatment

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Tomasz Gorycki ◽  
Michał Studniarek
Keyword(s):  
Differential Diagnosis ◽  
Bile Duct ◽  
Endoscopic Treatment ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Biliary Duct ◽  
Linear Measurements ◽  
Diagnosis And Prognosis ◽  
Signal Characteristics ◽  
Malignant Lesions ◽  
Solid Lesions

The aim of the study was to assess how realiable is differential diagnosis and prognosis for endoscopic treatment with MR signal characteristics as the qualitative parameter and magnetic resonance cholangiopancreatography (MRCP) images in cases of bile duct obstructions caused by solid masses.Material and Methods. Retrospective study of MR and MRCP images in 80 patients (mean age 58 ys) was conducted. Mean signal intensity ratio (SIR) from planar MR images and MRCP linear measurements were compared between benign and malignant lesions and in groups including the size and number of stents placed during ERCP (< 10 F <) in 51 cases in which ERCP was performed.Results. Significantly higher SIR values were encountered in malignant lesions in T2W images () and STIR T2W images (). Malignant lesions were characterised by longer strictures () and greater proximal biliary duct dilatation (). High significance for predicting ERCP conditions was found with mean SIR in STIR T2W images and stricture length.Conclusion. Probability of malignancy of solid lesions obstructing biliary duct increased with higher SIR in T2W images and with longer strictures. Passing the stricture during ERCP treatment was easier and more probable in cases of shorter strictures caused by lesions with higher SIR in STIR T2W images.

scholarly journals Intrahepatic Cholangiocarcinoma with Ductal Plate Malformation-like Feature Associated with Bile Duct Adenoma

2015 ◽  
Vol 49 (6) ◽  
pp. 531-534 ◽  
Author(s):  
Ah-Young Kwon ◽  
Hye Jin Lee ◽  
Hee Jung An ◽  
Haeyoun Kang ◽  
Jin-Hyung Heo ◽  
...  
Keyword(s):  
Bile Duct ◽  
Intrahepatic Cholangiocarcinoma ◽  
Ductal Plate ◽  
Ductal Plate Malformation ◽  
Bile Duct Adenoma

Small Glandular Proliferations of the Breast With Absent or Attenuated Myoepithelial Reactivity by Immunohistochemistry: A Review Focusing on the Differential Diagnosis and Interpretative Pitfalls

2016 ◽  
Vol 140 (7) ◽  
pp. 651-664
Author(s):  
Paula S. Ginter ◽  
Sandra J. Shin ◽  
Timothy M. D'Alfonso
Keyword(s):  
Differential Diagnosis ◽  
Immunohistochemical Staining ◽  
Clinical Case ◽  
Invasive Carcinoma ◽  
Data Sources ◽  
Benign Lesions ◽  
Immunohistochemical Markers ◽  
Malignant Lesions ◽  
Histopathologic Features ◽  
Rule Out

Context.—Small glandular proliferations of the breast encompass a variety of benign, atypical, and malignant lesions that show some overlapping morphologic features. Myoepithelial stains are frequently used in the workup of these lesions in order to rule out or establish a diagnosis of invasive carcinoma. Some benign lesions show absent or diminished myoepithelial staining, and may represent an interpretative pitfall, particularly in small core biopsy samples. Objective.—To review small glandular proliferations of the breast that show absent or diminished staining with myoepithelial immunohistochemical markers. Data Sources.—The study comprised a review of published literature and clinical case material. Conclusions.—The interpretation of myoepithelial stains in small glandular proliferations of the breast can, on some occasions, represent a challenge in diagnosing these lesions. Recognition of the key histopathologic features and immunohistochemical staining patterns of the entities in the differential diagnosis is crucial in their workup.

scholarly journals A Case of Intrahepatic Cholangiocarcinoma in a Bile Duct Adenoma

2013 ◽  
Vol 46 (5) ◽  
pp. 356-361
Author(s):  
Hidetaka Sugihara ◽  
Akira Chikamoto ◽  
Shin-ichi Akaboshi ◽  
Hiroyuki Komori ◽  
Masayuki Watanabe ◽  
...  
Keyword(s):  
Bile Duct ◽  
Intrahepatic Cholangiocarcinoma ◽  
Bile Duct Adenoma

Bile duct adenoma may be a precursor lesion of small duct type intrahepatic cholangiocarcinoma

2020 ◽  
Vol 78 (2) ◽  
pp. 310-320
Author(s):  
Motoko Sasaki ◽  
Yasunori Sato ◽  
Yasuni Nakanuma
Keyword(s):  
Bile Duct ◽  
Intrahepatic Cholangiocarcinoma ◽  
Precursor Lesion ◽  
Small Duct ◽  
Bile Duct Adenoma

Intrahepatic Cholangiocarcinoma Coexisting With Multiple Bile Duct Adenoma Treated as Liver Metastasis from a Pancreatic Neuroendocrine Tumor

2021 ◽  
Vol 41 (10) ◽  
pp. 5249-5254
Author(s):  
ERI ODA ◽  
KENSUKE YAMAMURA ◽  
YOSHIHIRO HARA ◽  
KAZUKI MATSUMURA ◽  
SHINICHI AKAHOSHI ◽  
...  
Keyword(s):  
Bile Duct ◽  
Liver Metastasis ◽  
Neuroendocrine Tumor ◽  
Intrahepatic Cholangiocarcinoma ◽  
Pancreatic Neuroendocrine Tumor ◽  
Bile Duct Adenoma

Long-term outcomes in the repair of intrahepatic iatrogenic bile duct lesions using a combined intraglissonian and extraglissonian approach

2021 ◽  
Author(s):  
Víctor Lopez-Lopez ◽  
David Ferreras ◽  
Asuncion Lopez-Conesa ◽  
Roberto Brusadin ◽  
Jose Cutillas ◽  
...  
Keyword(s):  
Bile Duct ◽  
Long Term Outcomes ◽  
Bile Duct Lesions

scholarly journals Cardiac magnetic resonance imaging in differential diagnosis of cardiac masses

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
EC D"angelo ◽  
P Paolisso ◽  
L Bergamaschi ◽  
A Foa ◽  
I Magnani ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Pericardial Effusion ◽  
Tissue Characterization ◽  
Descriptive Analysis ◽  
Gadolinium Enhancement ◽  
Malignant Lesions ◽  
T1 And T2 ◽  
Cardiac Masses

Abstract Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): S. Orsola Hospital Background  Differential diagnosis of cardiac masses represents a challenging issue with important implications for therapeutic management and patient’s prognosis. Cardiac Magnetic Resonance (CMR) is a non-invasive imaging technique used to characterize morphologic and functional features of masses. Integration of these information can lead an accurate diagnosis. Purpose  To evaluate the diagnostic role of CMR in defining the nature of cardiac masses. Methods : Ninety-three patients with cardiac masses evaluated with CMR were enrolled. All masses had histological certainty. CMR sequences allowed a qualitative morphologic description as well as tissue characterization. Evaluation of masses morphology included localization, size and borders assessment, detection of potential multiple lesions and pericardial effusion. Tissue characterization resulted from an estimation of contrast enhancement - early gadolinium enhancement (EGE) and late gadolinium enhancement (LGE) sequences - and tissue homogeneity in T1 and T2 weighted acquisitions. The descriptive analysis was carried out by comparing benign vs malignant lesions as well as dividing patients into 4 subgroups: primitive benign tumours, primitive malignant tumours, metastatic tumours and pseudotumours.  Results  The descriptive analysis of the morphologic features showed that diameter &gt; 50mm, invasion of surrounding planes, irregular margins and presence of pericardial effusion were able to predict malignancy (p &lt; 0.001). As for tissue characteristics, heterogeneous signal intensity - independently from T1 and T2 weighted acquisitions - and EGE were more common in malignant lesions (p &lt;0.001). When analysing the four subgroups, CMR features did not discriminate between primitive malignant masses and metastasis. Conversely, hyperintensity signal and EGE were able to distinguish benign primitive lesions from pseudotumors (p = 0.002).  Furthermore, using classification and regression tree (CART) analysis, we developed an algorithm to differentiate masses: invasion of surrounding planes was a common characteristic of malignancy and identifies itself malignant tumors. In the absence of invasive features, gadolinium enhancement was evaluated: the lack of contrast uptake was able to exclude a pseudotumor diagnosis and reduced the probability of a primary benign tumor.  Conclusions Cardiac magnetic resonance is a very powerful diagnostic tool for differential diagnosis of cardiac masses as it correctly addresses malignancy. Furthermore, an accurate evaluation of the several CMR features, may discriminate primary benign masses and pseudotumours. Abstract Figure. Benign and malignant cardiac masses

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