Clinicopathologic Study on Combined Hepatocellular Carcinoma and Cholangiocarcinoma: with Emphasis on the Intermediate Cell Morphology.
10.3346/jkms.2011.26.8.1023
- Author:
Ho Sung PARK
1
;
Jun Sang BAE
;
Kyu Yun JANG
;
Ju Hyung LEE
;
Hee Chul YU
;
Ji Hyeon JUNG
;
Baik Hwan CHO
;
Myoung Ja CHUNG
;
Woo Sung MOON
Author Information
1. Department of Pathology, Chonbuk National University Medical School, Institute for Medical Sciences, Research Institute of Clinical Medicine, Jeonju, Korea. mws@chonbuk.ac.kr
- Publication Type:Case Reports ; Research Support, Non-U.S. Gov't
- Keywords:
Carcinoma;
Hepatocellular;
Cholangiocarcinoma
- MeSH:
Adult;
Aged;
Antigens, Neoplasm/metabolism;
Carcinoma, Hepatocellular/*pathology;
Cell Adhesion Molecules/metabolism;
Cholangiocarcinoma/*pathology;
Female;
Humans;
Immunophenotyping;
Keratin-19/metabolism;
Keratin-7/metabolism;
Liver Neoplasms/*pathology;
Male;
Middle Aged;
Neural Cell Adhesion Molecules/metabolism;
Prognosis;
Proto-Oncogene Proteins c-kit/metabolism;
alpha-Fetoproteins/analysis
- From:Journal of Korean Medical Science
2011;26(8):1023-1030
- CountryRepublic of Korea
- Language:English
-
Abstract:
Combined hepatocellular carcinoma and cholangiocarcinoma (combined HCC-CC) is a rare subtype of primary liver cancer. We investigated the histopathologic features of transitional or intermediate areas in 21 combined HCC-CCs and immunophenotypes using different hepatic progenitor cell markers (CK7, CK19, c-kit, NCAM, and EpCAM). Major histologic findings of transitional or intermediate areas of 21 combined HCC-CCs included strands/trabeculae of small, uniform, oval-shaped cells with scant cytoplasm and hyperchromatic nuclei embedded within an abundant stroma, small cells with an antler-like anastomosing pattern, and solid nests of intermediate hepatocyte-like cells surrounded by small cells in periphery, in order of frequency. The intermediate area of one tumor was composed predominantly of spindle cells arranged in short fascicles. Immunophenotype of tumor cells with intermediate morphology suggested a progenitor cell origin for this tumor. Clinical findings of combined HCC-CC showed a closer resemblance with those of HCC than those of CC. In univariate analysis, tumor size, TNM stage, and serum alpha-fetoprotein levels showed a significant association with poor patient survival. Serum alpha-fetoprotein level was an independent prognostic indicator in multivariate analysis. In conclusion, an awareness of the clinicopathologic features, specifically the various morphologic features of intermediate areas in this tumor, is essential for prevention of potential misdiagnosis as another tumor.
