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Mustapar N, Zawawi MSF, Tuan Sharif SE. The Value of H3K27me3 Immunohistochemistry in Differentiating Malignant Peripheral Nerve Sheath Tumour with Its Histologic Mimickers. Asian Pac J Cancer Prev 2020; 21:699-705. [PMID: 32212796 PMCID: PMC7437312 DOI: 10.31557/apjcp.2020.21.3.699] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Indexed: 12/17/2022] Open
Abstract
Background: Diagnosis of malignant peripheral nerve sheath tumor (MPNST) is rather challenging due to its divergent morphologic heterogeneity and lack of specific ancillary test. The emergence of H3K27 trimethylation (H3K27me3) as a new immunohistochemistry (IHC) marker for MPNST have recently available to assist pathologists in differentiating MPNST from other histologic mimics. We aim to study the expression pattern of H3K27me3 in MPNST and its histologic mimickers and their association with the clinicopathological data. Methodology: A total of 59 benign and malignant spindle cell tumours (18 MPNST and 41 of its histologic mimickers which included 10 schwannoma, 13 neurofibroma, 4 synovial sarcoma, 3 fibrosarcoma, 2 gastrointestinal stromal tumour (GIST), 4 leiomyosarcoma, 1 spindle cell liposarcoma, 1 solitary fibrous tumour, 2 low grade fibromyxoid sarcoma and 1 unclassified spindle cell sarcoma), diagnosed from January 1998 to April 2018 in Hospital Universiti Sains Malaysia (HUSM) were tested for H3K27me3 by IHC. The MPNST histological grade was assessed based on the French Fe’de’ ration Nationale des Centres de LutteContre le Cancer (FNCLCC) for 3 tiers system (low grade, intermediate grade and high grade). The clinicopathological data were retrieved from the patients’ record. Results: A total of 61.1% (11/18 MPNST) showed loss of H3K27me3 expression which is statistically significant as compared to its histologic mimics (p<0.001). Similar findings (p=0.026) were also observed in high grade MPNST (81.8%), intermediate grade MPNST (100%) and 0% in low grade MPNST. Conclusion: H3K27me3, combined with other panel of markers, is useful in MPNST diagnosis to differentiate it from the histological mimickers.
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Affiliation(s)
- Nurulhasanah Mustapar
- Department of Pathology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia.,Department of Pathology and Laboratory Medicine, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
| | - Muhamad Syahrul Fitri Zawawi
- Department of Orthopedics, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia
| | - Sharifah Emilia Tuan Sharif
- Department of Pathology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia.,Department of Pathology, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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McCarthy AJ, Karamchandani DM, Chetty R. Neural and neurogenic tumours of the gastroenteropancreaticobiliary tract. J Clin Pathol 2018; 71:565-578. [PMID: 29419412 DOI: 10.1136/jclinpath-2017-204895] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 01/12/2018] [Accepted: 01/13/2018] [Indexed: 12/11/2022]
Abstract
Neural lesions occur uncommonly in the gastroenteropancreaticobiliary tract. However, due to the growing number of screening colonoscopy procedures, polypoid neural lesions of the colon are being recognised increasingly and range from benign tumours to high-grade malignant neoplasms. Morphological variability of neural tumours can be wide, although some entities share pathological features, and, as such, these lesions can be diagnostically challenging. We review the spectrum of pathology of neural tumours in the gastroenteropancreaticobiliary tract, with the goal of providing a practical approach for practising surgical pathologists.
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Affiliation(s)
- Aoife J McCarthy
- Department of Pathology, Laboratory Medicine Program, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Dipti M Karamchandani
- Department of Pathology, Division of Anatomic Pathology, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Runjan Chetty
- Department of Pathology, Laboratory Medicine Program, University Health Network and University of Toronto, Toronto, Ontario, Canada
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Haradome H, Woo J, Nakayama H, Watanabe HN, Ogawa M, Moriyama M, Sugitani M, Takayama T, Abe O. Characteristics of Hepatic Schwannoma Presenting as an Unusual Multi-cystic Mass on Gadoxetic Acid Disodium-enhanced MR Imaging. Magn Reson Med Sci 2018; 17:95-99. [PMID: 28190852 PMCID: PMC5760239 DOI: 10.2463/mrms.cr.2016-0101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Hepatic schwannoma is a very rare hepatic tumor, usually appearing as a hypervascular solid mass with or without various degrees of cystic changes; however, to the best of our knowledge, only the two cases of hepatic schwannoma showing a multi-cystic appearance have previously been reported. We report herein a benign hepatic schwannoma presenting as an unusually large multi-cystic mass. The gadoxetic acid disodium-enhanced magnetic resonance imaging features are described with the histopathologic correlation and briefly review the literature. The solid-like areas showing the early/progressive enhancement, reflecting remnants of the Antoni A/B portion, during the dynamic phases may be helpful imaging features for the differentiation of other multi-cystic hepatic lesions, but pathological evaluation remains essential for diagnosis.
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Affiliation(s)
- Hiroki Haradome
- Department of Radiology, Nihon University School of Medicine
| | - Jun Woo
- Department of Radiology, Nihon University School of Medicine
| | - Hisashi Nakayama
- Department of Digestive Surgery, Nihon University School of Medicine
| | | | - Masahiro Ogawa
- Department of Gastroenterology, Nihon University School of Medicine
| | | | | | | | - Osamu Abe
- Department of Radiology, Graduate School of Medicine, The University of Tokyo
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Jung HI, Lee HU, Ahn TS, Lee JE, Lee HY, Cho HD, Lee SC, Bae SH. Primary hepatic malignant peripheral nerve sheath tumor successfully treated with combination therapy: a case report and literature review. Ann Surg Treat Res 2016; 91:327-331. [PMID: 27904856 PMCID: PMC5128380 DOI: 10.4174/astr.2016.91.6.327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 06/02/2016] [Accepted: 06/30/2016] [Indexed: 11/30/2022] Open
Abstract
Primary malignant peripheral nerve sheath tumor (MPNST) in a young female patient, not associated with neurofibromatosis type-I is extremely rare in the liver. A 33-year-old female was admitted with a right flank pain for a weak. The CT scan showed 12.5-cm-sized mass located at the right hepatic lobe. At laparotomy, about 20.0-cm-sized mass was on the right hepatic lobe with attachment to right diaphragmatic pleura. Right hepatic lobe and adherent part of diaphragmatic pleura were resected. On histology and immunohistochemistry, it was diagnosed MPNST. Adjuvant radiotherapy for the right diaphragmatic pleura and adjuvant chemotherapy with adriamycin, ifosfamide and cisplatin were sequentially performed. The prognosis of MPNST is generally poor and it is associated with a highly aggressive course of recurrence, metastases, and death. Our case is probably a first report about combination therapy.
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Affiliation(s)
- Hae Il Jung
- Department of Surgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Hyoung Uk Lee
- Department of Surgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Tae Sung Ahn
- Department of Surgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Jong Eun Lee
- Department of Surgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Hyun Yong Lee
- Department of Surgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Hyon Doek Cho
- Department of Pathology, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Sang Cheol Lee
- Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Sang Ho Bae
- Department of Surgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
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Yamamoto M, Hasegawa K, Arita J, Maeno R, Akamatsu N, Kaneko J, Watadani T, Okura N, Hayashi A, Shibahara J, Sakamoto Y, Ohtomo K, Fukayama M, Kokudo N. Primary hepatic schwannoma: A case report. Int J Surg Case Rep 2016; 29:146-150. [PMID: 27855352 PMCID: PMC5114688 DOI: 10.1016/j.ijscr.2016.11.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 11/05/2016] [Indexed: 02/07/2023] Open
Abstract
A hepatic schwannoma is extremely rare and difficult to diagnose preoperatively. We attempted to gain the radiological feature of the hepatic schwannoma by reviewing case reports. If the hepatic tumor is diagnosed as a schwannoma preoperatively, surgical resection is highly recommended.
Introduction A hepatic schwannoma is extremely rare and difficult to diagnose preoperatively. Presentation of case We report the case of a 47-year-old male patient who was referred to our hospital for the close investigation of a hepatic tumor which had not been detected two years earlier. An enhanced computed tomography revealed a well-circumscribed and encapsulated tumor with a size of 50 mm which was adjacent to the inferior vena cava (IVC) and the right hepatic vein. The tumor was heterogeneously enhanced until the equilibrium phase. A magnetic resonance image showed a hypointense area on a T1-weighted image and a hyperintense area on a T2-weighted image. These findings differed from those of common malignant hepatic tumors, such as hepatocellular carcinoma and colorectal liver metastases. The tumor was most likely a mucus-producing tumor or a liquefactive degenerated adenocarcinoma. Although we could not confirm an exact diagnosis of the tumor, we performed a surgical resection in view of the possibility of malignancy. The patient underwent a limited liver resection with resection of the IVC. Histologically, the tumor was diagnosed as a benign schwannoma comprised of Antoni A and B areas. The nuclear palisading formation of the tumor showed Verocay bodies. Discussion 15 cases of hepatic schwannoma are reviewed to clarify the typical radiological features. The radiological findings of the present case were consistent with those of the hepatic schwannoma when considering retrospectively. Conclusion A precise preoperative diagnosis of hepatic schwannoma is difficult, and liver resection is recommended when a hepatic schwannoma is suspected.
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Affiliation(s)
- Masaki Yamamoto
- Hepato-Biliary-Pancreatic Surgery Division and Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Kiyoshi Hasegawa
- Hepato-Biliary-Pancreatic Surgery Division and Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
| | - Junichi Arita
- Hepato-Biliary-Pancreatic Surgery Division and Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Ryohei Maeno
- Hepato-Biliary-Pancreatic Surgery Division and Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Nobuhisa Akamatsu
- Hepato-Biliary-Pancreatic Surgery Division and Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Junichi Kaneko
- Hepato-Biliary-Pancreatic Surgery Division and Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Takeyuki Watadani
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Naoki Okura
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Akimasa Hayashi
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Junji Shibahara
- Department of Pathology, Kyorin University School of Medicine, Mitaka, Tokyo 181-8611, Japan
| | - Yoshihiro Sakamoto
- Hepato-Biliary-Pancreatic Surgery Division and Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Kuni Ohtomo
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Masashi Fukayama
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Norihiro Kokudo
- Hepato-Biliary-Pancreatic Surgery Division and Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
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Wan DAL, Zhai ZL, Ren KW, Yang YC, Lin SZ, Zheng SS. Hepatic schwannoma: A case report and an updated 40-year review of the literature yielding 30 cases. Mol Clin Oncol 2016; 4:959-964. [PMID: 27313857 DOI: 10.3892/mco.2016.850] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 02/25/2016] [Indexed: 12/21/2022] Open
Abstract
Hepatic schwannoma is a rare benign disease with a good prognosis. Early diagnosis is difficult due to the absence of specific clinical presentations and its rarity. The present study briefly described a 64-year-old female patient with hepatic schwannoma mimicking intrahepatic cholangiocarcinoma. Furthermore, the clinical data of 30 patients with hepatic schwannoma were also reviewed and analyzed. The mean age of the 30 patients was 51.7 years (range, 21-83 years) and ~2/3 were female. All patients in the benign group underwent surgical treatment and survived until the last follow-up, of whom 19 received complete resection and the remaining 1 underwent liver transplantation. However, in the malignant group, only three cases who underwent the surgical resection remained alive at last follow-up. Another seven cases were succumbed to mortality, 4 cases of whom had deteriorated to have no operation opportunity by the time they saw a doctor, and among the remaining three cases with hepatectomy, 1 died of liver dysfunction at 21 days postoperatively, 2 succumbed to recurrences at 18 and 23 months postoperatively. In conclusion, hepatic schwannoma is a rare benign disease with a good prognosis. However, once the malignant transformation occurs, the prognosis is not satisfied. Complete resection is the mainstay for cure and liver transplantation is often necessary.
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Affiliation(s)
- DA-Long Wan
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang 310003, P.R. China; Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, The First Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang 310003, P.R. China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang 310003, P.R. China
| | - Zheng-Long Zhai
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang 310003, P.R. China; Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, The First Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang 310003, P.R. China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang 310003, P.R. China
| | - Kui-Wu Ren
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang 310003, P.R. China; Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, The First Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang 310003, P.R. China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang 310003, P.R. China
| | - Yun-Chuan Yang
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang 310003, P.R. China; Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, The First Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang 310003, P.R. China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang 310003, P.R. China
| | - Sheng-Zhang Lin
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang 310003, P.R. China; Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, The First Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang 310003, P.R. China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang 310003, P.R. China
| | - Shu-Sen Zheng
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang 310003, P.R. China; Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, The First Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang 310003, P.R. China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang 310003, P.R. China
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Feng LH, Dong H, Zhu YY, Cong WM. An update on primary hepatic solitary fibrous tumor: An examination of the clinical and pathological features of four case studies and a literature review. Pathol Res Pract 2015; 211:911-7. [PMID: 26601735 DOI: 10.1016/j.prp.2015.09.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 09/02/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND Primary hepatic solitary fibrous tumor is a rare neoplasm that originates in the submesothelial tissue of the liver and is frequently misdiagnosed because of its rarity and unfamiliar characteristics. AIM To analyze, summarize and update the clinical and pathological features of primary hepatic solitary fibrous tumor. METHODS We systematically extract the clinical data of 4 cases from the relevant medical records, analyze the macroscopic, histological and immunohistochemical features and review the 59 previously reported cases in the English literatures. RESULTS The patients' mean age 50.75 years (range, 49-52 years), and the gender ratio was 1:1. The tumors ranged in size from 2.3 to 12.0cm (average diameter, 7.85cm). The tumors were composed of spindle cells with oval, fusiform or banded nuclei that were arranged in bundled, storiform or peculiar random patterns. Mitosis and hemangiopericytoma-like vessels were occasionally observed. Immunohistochemically, three cases were positive for Signal transduction and activator of transcription 6, cluster of differentiation 34, B-cell lymphoma-2 and vimentin but were negative for nervous, muscular and hepatocellular markers. Hepatic lobectomy was performed in all cases, and one patient received adjuvant chemotherapy simultaneously. One patient suffered two recurrences without metastasis, and the remaining patients experienced favorable outcomes. CONCLUSIONS A consensus on the essential and definite diagnostic criteria for primary hepatic solitary fibrous tumor must be reached in a timely manner. Signal transduction and activator of transcription 6 is a highly sensitive and specific immunohistochemical marker for primary hepatic solitary fibrous tumor.
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Affiliation(s)
- Long-Hai Feng
- Department of Pathology, Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, 225 Changhai Road, Yangpu, Shanghai 200438, China
| | - Hui Dong
- Department of Pathology, Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, 225 Changhai Road, Yangpu, Shanghai 200438, China
| | - Yu-Yao Zhu
- Department of Pathology, Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, 225 Changhai Road, Yangpu, Shanghai 200438, China
| | - Wen-Ming Cong
- Department of Pathology, Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, 225 Changhai Road, Yangpu, Shanghai 200438, China.
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Qiu LL, Yu RS, Chen Y, Zhang Q. Sarcomas of abdominal organs: computed tomography and magnetic resonance imaging findings. Semin Ultrasound CT MR 2012; 32:405-21. [PMID: 21963162 DOI: 10.1053/j.sult.2011.04.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Sarcomas originating from abdominal organs are extremely rare, and literature in which investigators focus on their imaging features is scarce. This article aims to review the computed tomography and magnetic resonance imaging features of these rare tumors and to help in clinical diagnosis. Various sarcomas (eg, angiosarcoma, undifferentiated embryonal sarcoma, leiomyosarcoma, carcinosarcoma, rhabdomyosarcoma) originating, respectively, from different abdominal visceral organs (liver, pancreas, spleen, kidney, adrenal gland, uterus, and prostate gland) are reviewed along with cases we encountered.
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Affiliation(s)
- Ling-Ling Qiu
- Department of Radiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Abstract
Primary malignant liver mesenchymal tumor is a rare condition defined as a tumor with vascular, fibrous, adipose, and other mesenchymal tissue differentiation. We report a case of primary malignant liver mesenchymal tumor in a 51-year-old male with anemia, weight loss and hepatomegaly. Finally unconventional liver biopsy and histological manifestation led to the definitive diagnosis.
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