The stromal morphological changes for differential diagnosis of uninodular high-grade dysplastic nodule and well-differentiated small hepatocellular carcinoma

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.

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The Differential Diagnosis of Small-Hepatocellular Carcinoma and Dysplastic Nodule in Patients with HBV Infection by Virtual Touch Tissue Quantification

10.1055/s-0037-1603703 ◽

2017 ◽

Author(s):

Yingying Liu ◽

Fajin Dong ◽

Zhang Lei ◽

Wu Qian ◽

Jinfeng Xu ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Differential Diagnosis ◽

Hbv Infection ◽

Small Hepatocellular Carcinoma ◽

Dysplastic Nodule ◽

Virtual Touch Tissue Quantification ◽

Tissue Quantification

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Using loss of heterozygosity of microsatellites to distinguish high-grade dysplastic nodule from early minute hepatocellular carcinoma

Experimental and Molecular Pathology ◽

10.1016/j.yexmp.2011.06.003 ◽

2011 ◽

Vol 91 (2) ◽

pp. 578-583 ◽

Cited By ~ 8

Author(s):

Hui Dong ◽

Wen-Ming Cong ◽

Zhi-Hong Xian ◽

Zhong-Zheng Zhu

Keyword(s):

Hepatocellular Carcinoma ◽

Loss Of Heterozygosity ◽

High Grade ◽

Dysplastic Nodule ◽

High Grade Dysplastic Nodule

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

Arquivos de Gastroenterologia ◽

10.1590/s0004-2803.202100000-14 ◽

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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Differentiation of regenerative nodule, dysplastic nodule, and small hepatocellular carcinoma in cirrhotic patients: a contrast-enhanced ultrasound–based multivariable model analysis

European Radiology ◽

10.1007/s00330-020-06834-5 ◽

2020 ◽

Vol 30 (9) ◽

pp. 4741-4751

Author(s):

Yu Duan ◽

Xiaoyan Xie ◽

Qian Li ◽

Nathaniel Mercaldo ◽

Anthony E. Samir ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Model Analysis ◽

Small Hepatocellular Carcinoma ◽

Contrast Enhanced Ultrasound ◽

Dysplastic Nodule ◽

Multivariable Model ◽

Regenerative Nodule ◽

Contrast Enhanced ◽

Cirrhotic Patients

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Well-differentiated intra-osseous osteosarcoma in the mandible of a six-year-old child

The Journal of Laryngology & Otology ◽

10.1017/s0022215100112642 ◽

1990 ◽

Vol 104 (4) ◽

pp. 335-340 ◽

Cited By ~ 4

Author(s):

P. L. James ◽

M. B. O'regan ◽

P. M. Speight

Keyword(s):

Differential Diagnosis ◽

Surgical Removal ◽

High Grade ◽

Large Tumour ◽

Desmoplastic Fibroma ◽

Subsequent Transformation ◽

Surgical Access ◽

Conventional Osteosarcoma ◽

Well Differentiated ◽

The Relationship

AbstractThe case of an osteosarcoma arising in the mandible of a six-year-old child is presented. It was originally misdiagnosed as a desmoplastic fibroma, and after initial curettage continued to grow for twelve years. The differential diagnosis is presented and details of the surgical access and difficulties encountered in the surgical removal of this very large tumour are described.The relationship between pre-existing disease and osteosarcoma of the mandible is discussed, and the difficulties experienced in distinguishing between the fibro-osseous lesions and osteosarcoma of the mandible are highlighted.The case is presented as a well-differentiated, intra-osseous osteosarcoma with subsequent transformation into a high-grade, conventional osteosarcoma.

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Recurrent hydrothorax due to diaphragmatic perforation post hepatocellular carcinoma radiofrequency ablation: A case report

Annals of Clinical Gastroenterology and Hepatology ◽

10.29328/journal.acgh.1001026 ◽

2021 ◽

Vol 5 (1) ◽

pp. 013-015

Author(s):

Aceituno Laia ◽

Prió Alba ◽

Ascanio Fernando L ◽

Serres-Créixams Xavier ◽

Mínguez Beatríz ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Differential Diagnosis ◽

Case Report ◽

Liver Disease ◽

Radiofrequency Ablation ◽

Fatty Liver Disease ◽

Safe Procedure ◽

Small Hepatocellular Carcinoma ◽

Fatal Complications ◽

Uncommon Complication

Radiofrequency ablation is one of the most commonly used therapies for potentially curative small hepatocellular carcinoma. Although radiofrequency is usually a safe procedure, severe and potentially fatal complications can happen. This is a case of a 72 years old woman with cirrhosis secondary to Metabolic Associated Fatty Liver Disease (MAFLD), who presented recurrent hydrothorax after treating hepatocellular carcinoma (HCC) with radiofrequency ablation (RFA), and in which diaphragmatic perforation was subsequently diagnosed. We reviewed the differential diagnosis and management in a pleural effusion after a radiofrequency procedure. Although diaphragmatic perforation is an uncommon complication after RFA procedure, this case aims to help clinicians being aware of non-habitual complications.

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