Undifferentiated liver cancer diagnosed by endoscopic ultrasound-guided fine needle aspiration:a case report and literature review
10.16781/j.CN31-2187/R.20240485
- VernacularTitle:超声内镜引导细针穿刺抽吸术诊断肝脏未分化癌1例及文献总结
- Author:
Wenhui XU
1
;
Binbin LI
Author Information
1. 海军军医大学(第二军医大学)第二附属医院病理科,上海 200433
- Keywords:
undifferentiated liver cancer;
pathology;
endoscopic ultrasound-guided fine needle aspiration;
histology;
immunohistochemistry
- From:
Academic Journal of Naval Medical University
2025;46(10):1371-1376
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the histological and immunohistochemical characteristics of undifferentiated liver cancer in small tissue biopsy specimens.Methods Endoscopic ultrasound-guided fine needle aspiration(EUS-FNA)was used to obtain liver tissue strips and cell samples.The tissue and cell morphology of a case of liver undifferentiated carcinoma were analyzed by hematoxylin-eosin staining,immunohistochemical staining,and cell smear techniques.The related literatures of undifferentiated liver cancer were retrieved from PubMed and Wanfang databases to summarize the diagnostic criteria of undifferentiated liver cancer.Results Histologically,this case of undifferentiated liver cancer presented as a patchy arrangement of oval or spindle shaped tumor cells,with large,deeply stained,and distinctly atypical anaplastic cells visible in between.Localized nuclear fission images could be observed.The cytological manifestation was nuclear atypical cells,with less cytoplasm in atypical cells,and some cells had red staining of cytoplasm resembling squamous cell carcinoma cytoplasm.The immunohistochemical results showed epithelial membrane antigen(EMA)(+),cytokeratin(CK)18(+),glutamine synthetase(GS)(-),carbohydrate antigen 19-9(CA19-9)(-),vimentin(-),CK7(-),CK20(-),alpha fetoprotein(AFP)(-),glypican 3(Gpc-3)(-),hepatocellular paraffin antigen-1(Hep-1)(-),and chromogranin A(CgA)(-).The results of literature review showed that undifferentiated liver cancer was more common in middle-aged and elderly men,and generally appeared as isolated circular nodules.In 8 out of 9 cases,tumor cells were observed to grow diffusely under the microscope,and no typical glandular or beam like growth patterns of liver tumors were observed.The malignant degree of tumor cells was high,with 5 out of 9 cases showing significantly atypical interstitial cells.Immunohistochemical features included positive expression of epithelial derived markers(such as pan cytokeratin[CKpan],EMA,and CK18)and negative expression of liver derived markers(AFP,Hep-1,Gpc-3,and arginase-1),which might be accompanied by positive expression of neuroendocrine markers.Conclusion The histological morphology of undifferentiated liver cancer is characterized by diffuse distribution of anaplastic cells,without any glandular or cord like arrangement.The tumor often expresses epithelial derived markers,while liver derived markers show negative expression.
