Fibrolamellar Carcinoma With Predominantly Pseudoglandular Architecture: A Potential Diagnostic Pitfall

Differential Diagnosis ◽

Systematic Approach ◽

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).

Power Doppler imaging of hepatic tumours: Differential diagnosis between hepatocellular carcinoma and metastatic adenocarcinoma

Journal of Gastroenterology and Hepatology ◽

10.1111/j.1440-1746.1998.tb00593.x ◽

1998 ◽

Vol 13 (11) ◽

pp. 1152-1160 ◽

Cited By ~ 14

Author(s):

TOSHIHIKO KAWASAKI ◽

TOSHINAO ITANI ◽

HIROSHI NAKASE ◽

JUN MIMURA ◽

HIDESHI KOMORI ◽

...

Keyword(s):

Differential Diagnosis ◽

Power Doppler ◽

Doppler Imaging ◽

Power Doppler Imaging ◽

Hepatic Tumours

Utility of pancreatic digestive enzyme immunohistochemistry in the differential diagnosis of hepatocellular carcinoma, cholangiocarcinoma and metastatic adenocarcinoma of the liver

Pathology International ◽

10.1111/j.1440-1827.1996.tb03596.x ◽

1996 ◽

Vol 46 (3) ◽

pp. 183-188 ◽

Cited By ~ 5

Author(s):

Tadashi Terada ◽

Yasuni Nakanuma

Keyword(s):

Differential Diagnosis ◽

Digestive Enzyme ◽

Metastatic Adenocarcinoma

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

European Journal of Ultrasound ◽

10.1016/s0929-8266(98)00012-3 ◽

1998 ◽

Vol 7 (2) ◽

pp. 93-99 ◽

Cited By ~ 14

Author(s):

Agostino Colli ◽

Massimo Cocciolo ◽

Nicola Mumoli ◽

Lucia Cesarini ◽

Aniello Prisco ◽

...

Keyword(s):

Differential Diagnosis ◽

Ultrasound Findings

Comparison of Thyroid Transcription Factor-1 and Hepatocyte Antigen Immunohistochemical Analysis in the Differential Diagnosis of Hepatocellular Carcinoma, Metastatic Adenocarcinoma, Renal Cell Carcinoma, and Adrenal Cortical Carcinoma

American Journal of Clinical Pathology ◽

10.1309/kkdp-mnd2-w794-p9eh ◽

2002 ◽

Vol 118 (6) ◽

pp. 911-921 ◽

Cited By ~ 47

Author(s):

Tad J. Wieczorek ◽

Jack L. Pinkus ◽

Jonathan N. Glickman ◽

Geraldine S. Pinkus

Keyword(s):

Renal Cell Carcinoma ◽

Transcription Factor ◽

Differential Diagnosis ◽

Renal Cell ◽

Immunohistochemical Analysis ◽

Thyroid Transcription Factor 1 ◽

Thyroid Transcription Factor ◽

Transcription Factor 1

Intrahepatic cholangiocarcinoma and hepatocellular carcinoma: differential diagnosis with contrast-enhanced ultrasound

European Radiology ◽

10.1007/s00330-009-1599-8 ◽

2009 ◽

Vol 20 (3) ◽

pp. 743-753 ◽

Cited By ~ 98

Author(s):

Li-Da Chen ◽

Hui-Xiong Xu ◽

Xiao-Yan Xie ◽

Xiao-Hua Xie ◽

Zuo-Feng Xu ◽

...

Keyword(s):

Differential Diagnosis ◽

Contrast Enhanced Ultrasound ◽

Contrast Enhanced

High mobility group A1 is expressed in metastatic adenocarcinoma to the liver and intrahepatic cholangiocarcinoma, but not in hepatocellular carcinoma: its potential use in the diagnosis of liver neoplasms

Journal of Gastroenterology ◽

10.1007/s00535-003-1221-9 ◽

2003 ◽

Vol 38 (12) ◽

pp. 1144-1149 ◽

Cited By ~ 23

Author(s):

Nobutsugu Abe ◽

Takashi Watanabe ◽

Yumi Izumisato ◽

Yutaka Suzuki ◽

Tadahiko Masaki ◽

...

Keyword(s):

Liver Neoplasms ◽

High Mobility ◽

High Mobility Group ◽

Potential Use

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

Clinical Hemorheology and Microcirculation ◽

10.3233/ch-211145 ◽

2021 ◽

pp. 1-17

Author(s):

Yanling Chen ◽

Wenping Wang

Keyword(s):

Diagnostic Accuracy ◽

Publication Bias ◽

Likelihood Ratio ◽

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.