scholarly journals Primary Lymphoepithelioma-like Hepatocellular Carcinoma With Hepatic Cyst: a Case Report and Review of Literature

2021 ◽  
Author(s):  
Zhiqiang Yang ◽  
Shengwei Li ◽  
Junbo Li ◽  
Xinglang Wu ◽  
Jin Liu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Histopathological Examination ◽  
Lateral Lobe ◽  
Good Prognosis ◽  
Hepatic Cyst ◽  
Health Examination ◽  
Lymphocyte Infiltration ◽  
Ki 67 ◽  
First Case ◽  
First Choice

Abstract Background: Lymphoepithelioma-like hepatic carcinoma is a rare malignant tumor. It includes lymphoepithelioma-like hepatocellular carcinoma (LEL-HCC) and lymphoepithelioma-like intrahepatic cholangiocarcinoma (LEL-ICC). we report the first case of hepatic cyst and LEL-HCC, which is extremely rare among hepatocellular carcinoma.Case presentation: A 47-year-old female was admitted to our hospital with an unexpected health examination finding of liver nodules. Subsequently, the Computerized tomography (CT) revealed a tumor and a cyst. The Magnetic resonance imaging (MRI) found a 23×18 mm hepatic cyst in the right lobe of the liver and a 21×17 mm nodule in the left lateral lobe of the liver, and the nodule imaging was likely liver cancer. The patient underwent laparoscopic left lateral hepatectomy, and the histopathological examination revealed undifferentiated heterogeneous glandular epithelial cells with obvious lymphocyte infiltration. The Immunohistochemistry study CD3, CD20, Ki-67, CK, and CK19 results were positive, while CD10, P53, and CEA were negative in tumor tissues. Epstein-Barr virus (EBV) was negative in situ hybridization. For this patient, the LEL-HCC diagnostic was made according to the histopathological result. Surgical resection is the first choice for this kind of patients, but immunotherapy may be more promising for them in the future. Conclusion: LEL-HCC is a rare variant of HCC, characterized by dense lymphocyte infiltration and a good prognosis. We report the first patient with hepatic cysts and LEL-HCC, which is distinctly uncommon in the HCC patients. Because the hepatic cyst and tumor are similar in certain imaging studies, our work can provide information for clinical diagnosis.

scholarly journals Neuroendocrine tumor arising from the greater omentum treated with laparoscopic tumor resection: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Taichi Terai ◽  
Kenji Nakagawa ◽  
Kota Nakamura ◽  
Shunsuke Doi ◽  
Kohei Morita ◽  
...  
Keyword(s):  
Neuroendocrine Tumor ◽  
Histopathological Examination ◽  
Tumor Resection ◽  
Ventral Side ◽  
Greater Omentum ◽  
Preoperative Imaging ◽  
Ki 67 ◽  
Case Presentation ◽  
First Case ◽  
Omental Tumor

Abstract Background Primary omental tumors are extremely rare. Herein, we report the first case of a primary omental neuroendocrine tumor (NET). Case presentation A 59-year-old woman was referred to our hospital for the treatment of an 18-mm tumor located at the ventral side of the duodenum. No other tumor was detected. The preoperative imaging diagnosis was omental tumor. A laparoscopic tumor resection was performed. Histopathological examination revealed that the tumor consisted of cuboidal cells with eosinophilic, granular cytoplasm showing trabecular or ribbon architecture. No other component was seen. The mitotic count was of 5 per 10 high-power fields. Immunohistochemical staining was positive for chromogranin A, synaptophysin, and CD56. Her Ki-67 index was 5%. These results led to the diagnosis of grade 2 omental NET. The patient was discharged on the 3rd postoperative day without any complications and did not develop any recurrence for 3 years. Conclusions We encountered a very rare case of omental NET. Complete resection is recommended with minimally invasive surgery for the diagnosis of NET.

scholarly journals Diagnosis and treatment of metastatic alveolar echinococcosis in the brain of a Tibetan patient : A case report

2020 ◽  
Author(s):  
Chaonan Du ◽  
Qiang Zhang ◽  
Mingfei Yang ◽  
Xiumin Han ◽  
Yanqiu Sun ◽  
...  
Keyword(s):  
Alveolar Echinococcosis ◽  
Dna Analysis ◽  
Histopathological Examination ◽  
Diagnosis And Treatment ◽  
Enzyme Linked Immunosorbent Assay ◽  
Post Discharge ◽  
Ki 67 ◽  
Standard Drug ◽  
First Choice ◽  
The Brain

Abstract Background: A case of primary alveolar echinococcosis (AE) in the liver with kidney and brain metastases was treated at our hospital. The analysis of this case might provide suggestions for the diagnosis and treatment of other cases of AE in the brain. Methods : To determine the disease status of AE in the liver and brain in this patient, computed tomography (CT) of the abdomen and head magnetic resonance imaging (MRI) were performed before surgery. Additionally, the serum of the patient was analyzed using an enzyme linked immunosorbent assay (ELISA) for antibodies against echinococcus. The left pterional approach was selected for head surgery. Along the edema zone around the lesion, complete excision was performed encompassing an area of about 5 mm surrounding the lesion. After surgery, pathological and immunohistochemical examinations of the lesion were performed, and deoxyribonucleic acid (DNA) was extracted for molecular identification. This patient was followed up regularly post-discharge to evaluate the outcome. Results: Anti-echinococcus antibodies were strongly positive in the patient’s serum, and the eosinophil ratio was 20%. The head MRI showed a single lesion in the left temporal lobe. Multiple nodular and small cystic long T 1 short T 2 signals were seen in the lesions. An enhanced scan indicated multiple ring-enhancements, the boundary was unclear, and the size of lesion was 3.2 mm×1.8 mm. Neurological symptoms improved after the surgery. The result of histopathological examination was consistent with the characteristics of AE. Immunohistochemistry showed that the peripheral glial cells were positive for glial fibrillary acidic protein (GFAP) and the Ki-67 index was <3%. DNA analysis identified the parasite as the Asian strain of Echinococcus multilocularis, and the sequence identity with the reference strain was practically 100.00%. Conclusion: Surgery is still the first choice of treatment for single, superficial AE lesions, and those located in nonfunctional areas of the brain. It is suggested that early radical treatment and standard drug treatment of primary hepatic AE are important steps to avoid secondary encephalic AE. Patients need to take albendazole for a long time after the operation, and should be followed-up regularly.

scholarly journals Case Report: Surgical Therapy for Left Innominate Vein Aneurysm Under Thoracoscopy

2021 ◽  
Vol 8 ◽  
Author(s):  
Yan Hu ◽  
Siying Ren ◽  
Chao Zeng ◽  
Jina Li ◽  
Min Zou ◽  
...  
Keyword(s):  
Mediastinal Mass ◽  
Thoracoscopic Surgery ◽  
Median Sternotomy ◽  
Innominate Vein ◽  
Anterior Mediastinal Mass ◽  
Health Examination ◽  
Thoracoscopic Approach ◽  
First Case ◽  
First Choice ◽  
Left Innominate Vein

Left innominate vein aneurysm is extremely rare, with a limited number of case reports present in the literature. Herein, we report a case of a 50-year-old female patient presenting with an incidental finding of an anterior mediastinal mass on chest radiography during a routine health examination. Contrast-enhanced computerized tomography (CT) of the chest showed a 4.8 × 4.6 cm anterior mediastinal mass with significant homogenous enhancement after injection of the contrast medium, suggesting a diagnosis of Castleman's disease, but not excluding thymoma. The patient underwent surgical resection of the anterior mediastinal mass under a thoracoscopic approach. Postoperative pathology confirmed the diagnosis of a left innominate vein aneurysm. This is the first case reporting a left innominate vein aneurysm resected under thoracoscopy. Despite this successful treatment experience, we need to emphasize that open thoracotomy or median sternotomy should be chosen as the first choice for surgeons who lack experience in thoracoscopic surgery, with the aim of avoiding intraoperative accidents.

A case of synchronous hepatocellular carcinoma and aortic body chemodectoma in a dog — Pathological case report

2011 ◽  
Vol 59 (1) ◽  
pp. 113-121
Author(s):  
Ágnes Sterczer ◽  
Tibor Németh ◽  
Míra Mándoki ◽  
Péter Gálfi ◽  
Csaba Jakab
Keyword(s):  
Hepatocellular Carcinoma ◽  
Neuroendocrine Tumour ◽  
Primary Liver Cancer ◽  
S100 Protein ◽  
Neuron Specific Enolase ◽  
Lateral Lobe ◽  
Distant Metastases ◽  
Primary Hepatocellular Carcinoma ◽  
Proliferation Index ◽  
Ki 67

The authors describe a case of synchronously occurring (double) tumours, i.e. primary hepatocellular carcinoma and aortic body chemodectoma in a 14-year-old mixed-breed male dog. The tumours were identified during necropsy, following euthanasia. In the last months of its life, the dog showed signs of weakness, anorexia, apathy, inactivity, and abdominal palpation elicited a painful reaction. The primary liver cancer emerged in the left lateral lobe without evidence of any distant metastases. Histopathological and immunohistochemical investigations revealed a well-differentiated, trabecular, claudin-7-, claudin-5- and pancytokeratin-negative hepatocellular carcinoma. The Ki-67 proliferation index was 33%. During necropsy, a synchronously occurring benign, grade I type aortic body chemodectoma was also detected in the dog. This neuroendocrine tumour showed chromogranin-, synaptophysin-, neuron-specific enolase- and S100 protein-positivity, and the Ki-67 proliferation index was 2%. The authors believe that this is the first description of synchronously occurring hepatocellular carcinoma and aortic body chemodectoma in a dog.

Intestinal Heterotopic Pancreas Involved by Simultaneous PanIN-2 Lesion and Endocrine Microadenoma: a Unique Case

2017 ◽  
Vol 26 (2) ◽  
pp. 199-202
Author(s):  
Remus Cornea ◽  
Sorina Taban ◽  
Cristian Suciu ◽  
Codruta Lazureanu ◽  
Alis Dema
Keyword(s):  
Histopathological Examination ◽  
Intraepithelial Neoplasia ◽  
Heterotopic Pancreas ◽  
Pancreatic Intraepithelial Neoplasia ◽  
Unique Case ◽  
Intraductal Papillary Mucinous Neoplasms ◽  
Pancreatic Endocrine Neoplasm ◽  
First Case ◽  
Mucinous Neoplasms

We hereby present the case of a 58-year-old male who underwent a total gastrectomy for gastric neoplasm. During the surgery, a tumor mass in the jejunum was identified, considered as metastasis, and resected. The histopathological examination of the jejunal lesion showed ectopic pancreas. In this area, two pathological distinct lesions were identified, one histologically compatible with pancreatic intraepithelial neoplasia (PanIN) type 2 lesion and the other with morphologic criteria for endocrine microadenoma. To our knowledge, this is the first case that evidences the presence of a concomitant premalignant exocrine lesion and benign endocrine lesion in a heterotopic pancreas (HP).Abbreviations: HP: heterotopic pancreas; IPMN: Intraductal Papillary Mucinous Neoplasms; PanIN: Pancreatic Intraepithelial Neoplasia; PEN: pancreatic endocrine neoplasm.

Expression of β-Catenin in Hepatocellular Carcinoma

2001 ◽  
Vol 71 (3) ◽  
pp. 116-125
Author(s):  
Norina Basa ◽  
Daniela Lazar ◽  
Remus Cornea ◽  
Sorina Taban ◽  
Melania Ardelean ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Cell Proliferation ◽  
Tumor Cell ◽  
Mitotic Index ◽  
Histological Grade ◽  
Proliferation Index ◽  
Tumor Cell Proliferation ◽  
Ki 67 ◽  
B Virus ◽  
Development And Evolution

Alteration of β-catenin expression is involved in the development and evolution of hepatocellular carcinoma (HCC); β-catenin is able to influence tumor cell proliferation. We analyzed the immunohistochemical (IHC) expression of β-catenin on a group of 32 patients diagnosed with HCC using the anti-β-catenin monoclonal antibody (clone E247). We correlated the expression of β-catenin with the proliferation index of Ki-67 (PI Ki-67), the mitotic index (MI) and other clinical and pathological features. We observed an altered β-catenin expression in 58.38% of all HCC cases. This expression was insignificantly correlated with tumor size (]5 cm) (p = 0.683), histological grade G1-G2 (p = 0.307), vascular invasion (p = 0.299) and advanced pT stage (p = 0.453); we obtained a significantly higher MI in HCC with altered β-catenin expression (p = 0.018), as compared to HCC without overexpression (1.66 � 1.37) (p = 0.038) and a PI Ki-67 of 22.49 � 20.1 and 28.24 � 18.2, respectively in tumors with altered β-catenin expression with insignificant differences compared to HCC without overexpression (25.95 � 15.2) (p = 0.682 and p = 0.731, respectively). According to the results we obtained, aberrant β-catenin expression in HCC was correlated with a high mitotic index, therefore playing an important role in tumor progression by stimulating tumor cell proliferation; non-nuclear β-catenin overexpression can have a pathological significance in HCC, especially in cases of HCC associated with hepatitis B virus (HBV) infection.

scholarly journals Expression and clinical significance of miR-3615 in hepatocellular carcinoma

2021 ◽  
Vol 49 (1) ◽  
pp. 030006052098154
Author(s):  
Xin Yuan ◽  
Yize Zhang ◽  
Zujiang Yu
Keyword(s):  
Hepatocellular Carcinoma ◽  
Survival Curve ◽  
Clinicopathological Characteristics ◽  
The Cancer Genome Atlas ◽  
Prognostic Information ◽  
Ki 67 ◽  
Tissue Samples ◽  
Expression Levels ◽  
Kaplan Meier ◽  
Serum Alpha Fetoprotein

Objective To investigate the association between microRNA-3615 (miR-3615) expression and the prognosis and clinicopathological features in patients with hepatocellular carcinoma (HCC). Methods We obtained clinicopathological and genomic data and prognostic information on HCC patients from The Cancer Genome Atlas (TCGA) database. We then analyzed differences in miR-3615 expression levels between HCC and adjacent tissues using SPSS software, and examined the relationships between miR-3615 expression levels and clinicopathological characteristics. We also explored the influence of miR-3615 expression levels on the prognosis of HCC patients using Kaplan–Meier survival curve analysis. Results Based on data for 345 HCC and 50 adjacent normal tissue samples, expression levels of miR-3615 were significantly higher in HCC tissues compared with adjacent tissues. MiR-3615 expression levels in HCC patients were negatively correlated with overall survival time and positively correlated with high TNM stage, serum Ki-67 expression level, and serum alpha-fetoprotein level. There were no significant correlations between miR-3615 expression and age, sex, and pathological grade. Conclusion MiR-3615 may be a promising new biomarker and prognostic factor for HCC.

scholarly journals Possible Role of IRS-4 in the Origin of Multifocal Hepatocellular Carcinoma

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2560
Author(s):  
Luis G. Guijarro ◽  
Patricia Sanmartin-Salinas ◽  
Eva Pérez-Cuevas ◽  
M. Val Toledo-Lobo ◽  
Jorge Monserrat ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cancer ◽  
Hepg2 Cells ◽  
Cellular Polarity ◽  
Ki 67 ◽  
Tissue Samples ◽  
Vitro Analysis ◽  
Tumoral Cells

New evidence suggests that insulin receptor substrate 4 (IRS-4) may play an important role in the promotion of tumoral growth. In this investigation, we have evaluated the role of IRS-4 in a pilot study performed on patients with liver cancer. We used immunohistochemistry to examine IRS-4 expression in biopsies of tumoral tissue from a cohort of 31 patient suffering of hepatocellular carcinoma (HCC). We simultaneously analyzed the expression of the cancer biomarkers PCNA, Ki-67, and pH3 in the same tissue samples. The in vitro analysis was conducted by studying the behavior of HepG2 cells following IRS-4 overexpression/silencing. IRS-4 was expressed mainly in the nuclei of tumoral cells from HCC patients. In contrast, in healthy cells involved in portal triads, canaliculi, and parenchymal tissue, IRS-4 was observed in the cytosol and the membrane. Nuclear IRS-4 in the tumoral region was found in 69.9 ± 3.2%, whereas in the surrounding healthy hepatocytes, nuclear IRS-4 was rarely observed. The percentage of tumoral cells that exhibited nuclear PCNA and Ki-67 were 52.1 ± 7%, 6.1 ± 1.1% and 1.3 ± 0.2%, respectively. Furthermore, we observed a significant positive linear correlation between nuclear IRS-4 and PCNA (r = 0.989; p < 0.001). However, when we correlated the nuclear expression of IRS-4 and Ki-67, we observed a significant positive curvilinear correlation (r = 0.758; p < 0.010). This allowed us to define two populations, (IRS-4 + Ki-67 ≤ 69%) and (IRS-4 + Ki-67 > 70%). The population with lower levels of IRS-4 and Ki-67 had a higher risk of suffering from multifocal liver cancer (OR = 16.66; CI = 1.68–164.8 (95%); p < 0.05). Immunoblot analyses showed that IRS-4 in normal human liver biopsies was lower than in HepG2, Huh7, and Chang cells. Treatment of HepG2 with IGF-1 and EGF induced IRS-4 translocation to the nucleus. Regulation of IRS-4 levels via HepG2 transfection experiments revealed the protein’s role in proliferation, cell migration, and cell-collagen adhesion. Nuclear IRS-4 is increased in the tumoral region of HCC. IRS-4 and Ki-67 levels are significantly correlated with the presence of multifocal HCC. Moreover, upregulation of IRS-4 in HepG2 cells induced proliferation by a β-catenin/Rb/cyclin D mechanism, whereas downregulation of IRS-4 caused a loss in cellular polarity and in its adherence to collagen as well as a gain in migratory and invasive capacities, probably via an integrin α2 and focal adhesion cascade (FAK) mechanism.

Primary stromal sarcoma of breast: A case report and literature review

2021 ◽  
pp. 1-7
Author(s):  
Mohammad Al-Wiswasy ◽  
Mahmoud Al-Balas ◽  
Raith Al-Saffar ◽  
Hamzeh Al-Balas
Keyword(s):  
Malignant Tumors ◽  
Histopathological Examination ◽  
Prognostic Significance ◽  
Total Duration ◽  
Young Patients ◽  
Soft Tissue Sarcomas ◽  
Breast Mass ◽  
Resection Margins ◽  
Stromal Sarcoma ◽  
First Case

INTRODUCTION: Primary breast sarcoma (PBS) was first described in 1887 as a rare heterogeneous neoplasm arising from the mesenchymal tissue of the mammary gland accounting for less than 5% of all body soft-tissue sarcomas and less than 0.1% of all malignant tumors of the breast. CASE PRESENTATION: A 31-year old lady presented with left breast mass which she felt four years before during which the mass increased in size from 1 to 6 cm in the largest diameter, diagnosed clinically as a benign fibroadenoma without any further cytological or histopathological confirmation. Histopathological examination of the excised breast mass reveals undifferentiated, primary stromal sarcoma of the breast (PSSB), which was followed by mastectomy three weeks later with reconstructive breast surgery with a total duration of follow-up of 3 years thereafter. This is the first case of PSSB reported in Jordan. DISCUSSION/CONCLUSION: PSSB is the generic term given to malignant breast tumors thought to arise from the specialized mesenchymal stroma of the breast but lacking an epithelial component with a phylloides pattern. PSSB is difficult to diagnose preoperatively due to its rarity and inadequate imaging methods to establish an exact diagnosis. The histology of the patient mass may be the leading factor for the management of these tumors. Even in very young patients, a progressively growing breast mass should alert the clinician to investigate for malignancy and verify the results by biopsy. Surgery with adequate resection margins represents the only potentially curative modality with prognostic significance. Adjuvant chemotherapy and radiotherapy are not very beneficial. The prognosis is dismal for patients with lymph node involvement and the size of the tumor has a lesser bearing on the outcome.

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