1
|
Wang J, Kang B, Sun C, Du F, Lin J, Ding F, Dai Z, Zhang Y, Yang C, Shang L, Li L, Hong Q, Huang C, Wang G. CT-based radiomics nomogram for differentiating gastric hepatoid adenocarcinoma from gastric adenocarcinoma: a multicentre study. Expert Rev Gastroenterol Hepatol 2023; 17:205-214. [PMID: 36625225 DOI: 10.1080/17474124.2023.2166490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND To develop a CT-based radiomics nomogram for the high-precision preoperative differentiation of gastric hepatoid adenocarcinoma (GHAC) patients from gastric adenocarcinoma (GAC) patients. RESEARCH DESIGN AND METHODS 108 patients with GHAC from 6 centers and 108 GAC patients matched by age, sex and T stage undergoing pathological examination were retrospectively reviewed. Patients from 5 centers were divided into two cohorts (training and internal validation) at a 7:3 ratio, the remaining patients were external test cohort. Venous-phase CT images were retrieved for tumor segmentation and feature extraction. A radiomics model was developed by the least absolute shrinkage and selection operator method. The nomogram was developed by clinical factors and the radiomics score. RESULTS 1409 features were extracted and a radiomics model consisting of 19 features was developed, which showed a favorable performance in discriminating GHAC from GAC (AUCtraining cohort = 0.998, AUCinternal validation set = 0.942, AUCexternal test cohort = 0.731). The radiomics nomogram, including the radiomics score, AFP, and CA72_4, achieved good calibration and discrimination (AUCtraining cohort = 0.998, AUCinternal validation set = 0.954, AUCexternal test cohort = 0.909). CONCLUSIONS The noninvasive CT-based nomogram, including radiomics score, AFP, and CA72_4, showed favorable predictive efficacy for differentiating GHAC from GAC and might be useful for clinical decision-making.
Collapse
Affiliation(s)
- Jing Wang
- Department of Radiology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Bing Kang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Cong Sun
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Fengying Du
- Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Jianxian Lin
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Fanghui Ding
- Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Zhengjun Dai
- Scientific Research Department, Huiying Medical Technology Co., Ltd,Beijing, China
| | - Yifei Zhang
- Department of Gastrointestinal Surgery, Yantai Yuhuangding Hospital Affiliated to Medical College of Qingdao University, Yantai, Shandong, China
| | - Chenggang Yang
- Department of Gastrointestinal Surgery, Liaocheng people's hospital, Liaocheng, Shandong, China
| | - Liang Shang
- Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Leping Li
- Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Qingqi Hong
- Department of Gastrointestinal Oncology Surgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China.,The School of Clinical Medicine, Fujian Medical University, The Graduate School of Fujian Medical University, Xiamen, Fujian, China
| | - Changming Huang
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Guangbin Wang
- Department of Radiology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China.,Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| |
Collapse
|
2
|
Collins K, Alkashash AM, Hwang M, Kaimakliotis HZ, Cheng L, Idrees MT. Somatic-Type Yolk Sac Tumor Arising as a Predominant Component of Bladder Urothelial Carcinoma. Int J Surg Pathol 2021; 30:207-213. [PMID: 34255554 DOI: 10.1177/10668969211030688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Germ cell differentiation has been described in association with somatic tumors arising from several organ systems; rare cases arising from urothelium have been reported. Here we present a 62-year-old male with a remote history of lung cancer, a left adrenal gland mass, and a 5.6 cm left bladder wall mass; cystoscopy demonstrated a large papillary mass on the left anterior bladder wall. A transurethral resection specimen was sent for review in consultation and showed extensive papillary structures with thin fibrovascular cores lined by neoplastic cells with clear cytoplasm. These neoplastic cells were diffusely positive for pancytokeratin, CDX2 (caudal-type homebox 2), SALL4 (sal-like transcription factor 4), glypican-3, AFP (alpha-fetoprotein), while negative for PAX-8 (paired box gene 8), NKX3.1 (NK3 homeobox 1), PSA (prostate specific antigen), TTF-1 (thyroid transcription factor 1), Napsin A, inhibin, and OCT4 (octamer-binding transcription factor 4). Conventional urothelial conventional carcinoma and focal squamous differentiation were also identified as minor components. Urothelial carcinoma was focally positive for GATA3 (GATA-binding protein 3) and p63; SALL4 and glypican-3 were negative. Overall findings supported a yolk sac tumor with a smaller component of squamous cell carcinoma (<1%). Subsequent cystectomy showed similar morphologic features and immunoprofile in addition to foci of urothelial carcinoma and urothelial carcinoma in situ. No chromosome 12p abnormalities were identified by fluorescent in-situ hybridization study. A diagnosis of yolk sac tumor derived from urothelial carcinoma was made. Yolk sac tumor should be considered in the differential diagnosis of a high-grade urothelial carcinoma, particularly when glandular or other unusual architectural patterns are present. A somatic origin with underlying genomic instability similar to what has been described in the uterus and ovaries is suggested.
Collapse
Affiliation(s)
- Katrina Collins
- 12250Department of Pathology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Ahmad M Alkashash
- 12250Department of Pathology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Michael Hwang
- 12250Department of Pathology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Hristos Z Kaimakliotis
- 12250Department of Urology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Liang Cheng
- 12250Department of Pathology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Muhammad T Idrees
- 12250Department of Pathology, Indiana University School of Medicine, Indianapolis, IN, USA
| |
Collapse
|
3
|
Abstract
Hepatoid adenocarcinoma of the urachus is a rare condition. We present the case of a 51-year-old female who developed abdominal pain and hematuria. Pelvic magnetic resonance imaging (MRI) reported an urachal mass with invasion to the bladder that was resected by partial cystectomy. On light microscopy the tumor resembled liver architecture, with polygonal atypical cells in nest formation and trabecular structures. Immunochemistry was positive for alfa-fetoprotein (AFP) and serum AFP was elevated. Hepatoid adenocarcinomas have been reported in multiple organs, being most commonly found in the stomach and the ovaries. Bladder compromise has been rarely described in the literature, and it has been associated with poor prognosis, low remission rates, and early metastasis.
Collapse
|
4
|
Ye J, Xu X, Fan M, Xue D, Zhuang Q. AFP-producing urothelial carcinoma of the bladder: a case report. Int Urol Nephrol 2014; 46:1527-9. [DOI: 10.1007/s11255-014-0691-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 02/28/2014] [Indexed: 11/28/2022]
|
5
|
|
6
|
Sekino Y, Mochizuki H, Kuniyasu H. A 49-year-old woman presenting with hepatoid adenocarcinoma of the urinary bladder: a case report. J Med Case Rep 2013; 7:12. [PMID: 23302376 PMCID: PMC3545894 DOI: 10.1186/1752-1947-7-12] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Accepted: 11/30/2012] [Indexed: 11/13/2022] Open
Abstract
Introduction Adenocarcinomas represent less than 2 percent of all urothelial neoplasms. Hepatoid adenocarcinoma is rare in the urinary bladder. Pathological diagnosis is based on a combination of histological features resembling hepatocellular carcinoma and positive immunostaining for α-fetoprotein. Case presentation We report a case of hepatoid adenocarcinoma of the urinary bladder. A 49-year-old Japanese woman underwent a total mastectomy, and post-operatively abdominal computed tomography revealed a tumor of the urinary bladder. Trans-urethral resection of the bladder tumor was performed, and pathological examination revealed a hepatoid adenocarcinoma of the urinary bladder. Our patient has had no evidence of recurrence 20 months after surgery to remove the tumor. Conclusions Hepatoid adenocarcinoma seems to be an aggressive malignant neoplasm that is rare in the urinary bladder. This case report is only the ninth case of hepatoid adenocarcinoma in the urinary bladder to appear in the literature. It is important to be aware of atypical cancer localizations in order to reach a correct diagnosis.
Collapse
Affiliation(s)
- Yohei Sekino
- Department of Urology, Miyoshi Central Hospital, 531 Higashisakaya, Hiroshima Prefecture, Miyoshi, Japan.
| | | | | |
Collapse
|
7
|
Lu HC, Chou FP, Yeh KT, Chang YS, Hsu NC, Chang JG. Expression of Protein Kinase C Family in Human Hepatocellular Carcinoma. Pathol Oncol Res 2009; 16:385-91. [DOI: 10.1007/s12253-009-9228-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2009] [Accepted: 11/10/2009] [Indexed: 11/28/2022]
|
8
|
Eom BW, Jung SY, Yoon H, Kook MC, Ryu KW, Lee JH, Kim YW. Gastric choriocarcinoma admixed with an α-fetoprotein-producing adenocarcinoma and separated adenocarcinoma. World J Gastroenterol 2009; 15:5106-8. [PMID: 19860007 PMCID: PMC2768893 DOI: 10.3748/wjg.15.5106] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
We report a case of gastric choriocarcinoma admixed with an α-fetoprotein (AFP)-producing adenocarcinoma. A 70-year-old man was hospitalized for gastric cancer that was detected during screening by esophagogastroduodenoscopy (EGD). Initial laboratory data showed the increased serum level of AFP and EGD revealed a 5-cm ulcerofungating mass in the greater curvature of the gastric antrum. The patient underwent radical subtotal gastrectomy with D2 lymph node dissection and Billroth II gastrojejunostomy. Histopathological evaluation confirmed double primary gastric cancer: gastric choriocarcinoma admixed with an AFP-producing adenocarcinoma and separated adenocarcinoma. At 2 wk postoperatively, his human chorionic gonadotropin and AFP levels had reduced and six cycles of adjuvant chemotherapy were initiated. No recurrence or distant metastasis was observed at 4 years postoperatively.
Collapse
|
9
|
Gálvez-Muñoz E, Gallego-Plazas J, Gonzalez-Orozco V, Menarguez-Pina F, Ruiz-Maciá JA, Morcillo MA. Hepatoid adenocarcinoma of the stomach - a different histology for not so different gastric adenocarcinoma: a case report. INTERNATIONAL SEMINARS IN SURGICAL ONCOLOGY : ISSO 2009; 6:13. [PMID: 19674468 PMCID: PMC2731104 DOI: 10.1186/1477-7800-6-13] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2009] [Accepted: 08/12/2009] [Indexed: 12/14/2022]
Abstract
Hepatoid adenocarcinoma is an extrahepatic tumor characterized by morphological similarities to hepatocellular carcinoma. Hepatoid adenocarcinoma of the stomach is a cancer with an extremely poor prognosis with few cases reported. Here, we describe a 75-year-old Spanish man referred to our hospital with a history of abdominal pain, general fatigue, anorexia and sickness. Initial study revealed anemia, and computed tomography scan and abdominal ultrasonography showed multiple metastases to the liver with hepatocellular carcinoma characteristics in a liver with no cirrhotic change. Further study included a serum level of alpha-fetoprotein (AFP), which resulted markedly elevated, and a conclusive esophagogastroduodenoscopy describing an elevated tumour growing through the cardia and gastroesophageal junction with foci of necrosis and haemorrhage. Gastric biopsies of the tumor revealed poorly differenciated adenocarcinoma, with hepatoid differentiation. After a diagnosis of AFP-producing hepatoid adenocarcinoma of the stomach with multiple liver metastases was made, pallitive total gastrectomy, without liver resection, was performed. Patient recovered well after surgery, and entered into a palliative systemich chemotherapy protocol. Although this illness is recognized as having poor prognosis, the patient remains alive 8 months after the operation. Accurate diagnosis of hepatoid adenocarcinoma of the stomach is important, and should be suspected under certain circumstances. We describe this rare case of hepatoid adenocarcinoma of the stomach, and review the literature concerning the clinicopathological aspects.
Collapse
Affiliation(s)
- Elisa Gálvez-Muñoz
- Department of Medical Oncology, Hospital General Universitario de Elche, Elche, Alicante, Spain
| | - Javier Gallego-Plazas
- Department of Medical Oncology, Hospital General Universitario de Elche, Elche, Alicante, Spain
| | | | | | - José A Ruiz-Maciá
- Department of Pathology, Hospital Vega Baja, Orihuela, Alicante, Spain
| | - Miguel A Morcillo
- Department of General Surgery, Hospital Vega Baja, Orihuela, Alicante, Spain
| |
Collapse
|
10
|
Lu CH, Chou WC, Hung YS, Yeh KY, Sheu S, Liaw CC. Alpha-fetoprotein-producing transitional cell carcinoma of the urinary bladder: a case report. Int Urol Nephrol 2008; 41:567-70. [DOI: 10.1007/s11255-008-9461-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2008] [Accepted: 08/12/2008] [Indexed: 12/13/2022]
|
11
|
Lopez-Beltran A, Requena MJ, Cheng L, Montironi R. Pathological variants of invasive bladder cancer according to their suggested clinical significance. BJU Int 2008; 101:275-81. [DOI: 10.1111/j.1464-410x.2007.07271.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
12
|
Thamboo TP, Wee A. Hep Par 1 expression in carcinoma of the cervix: implications for diagnosis and prognosis. J Clin Pathol 2004; 57:48-53. [PMID: 14693835 PMCID: PMC1770152 DOI: 10.1136/jcp.57.1.48] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
AIMS To determine the frequency and pattern of Hep Par 1 expression in cervical carcinomas of various histological types and to correlate expression with prognostic parameters. METHODS Twenty nine cervical carcinomas were analysed for tumour type, hepatoid and neuroendocrine differentiation, and vascular invasion. A semiquantitative analysis was performed for Hep Par 1, alpha fetoprotein, chromogranin, and synaptophysin immunoreactivity. RESULTS Hep Par 1 expression was seen in seven of the 29 cervical carcinomas (three of seven adenocarcinomas, one of 17 squamous cell carcinomas, one of two adenocarcinomas with adenocarcinoma in situ, one of two adenocarcinomas in situ, and one of one large cell neuroendocrine carcinoma with adenocarcinoma in situ). Normal looking endocervical epithelium was also positive in one case. Cases expressing Hep Par 1, with or without neuroendocrine coexpression, were associated with a higher rate of vascular invasion and a worse prognosis. Three of the five cases expressing neuroendocrine markers also coexpressed Hep Par 1. CONCLUSIONS Hep Par 1 expression in carcinoma of the cervix is not uncommon and is present in a variety of histological types. Expression of this marker appears to be associated with more aggressive biological behaviour and a worse prognosis. The uterine cervix is another site that may express Hep Par 1 and hence the use of this antibody in situations of diagnostic difficulty, especially involving lesions within the liver, have to be coupled with the knowledge of the range of tissues it may stain.
Collapse
Affiliation(s)
- T P Thamboo
- Department of Pathology, National University of Singapore, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074, Republic of Singapore.
| | | |
Collapse
|
13
|
Theuerkauf I, Axmann C, Wolff M, Tschubel K, Fischer HP. Malignant mediastinal germ cell tumor with pure hepatoid differentiation. Pathol Res Pract 2003; 198:725-9. [PMID: 12530574 DOI: 10.1078/0344-0338-00327] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We describe a germ cell tumor of anterior mediastinal origin, with pure hepatoid differentiation and elevated serum AFP in a 41-year-old man. This is the first report of such a neoplasm analyzed by conventional stains and immunohistochemistry. Hepatocellular differentiation was proved by immunoreactivity with HepPar-1 and alpha-fetoproein (AFP), membranous expression of carcinoembryonic antigen (CEA-poly) in a canalicuar pattern, and focal expression of cytokeratin 19 in abortive ductular structures. Our investigation shows that mediastinal germ cell tumors with hepatoid components typically arise in middle-aged men; they are of pure hepatoid differentiation, as demonstrated here, or exclusively associated with yolk sac structures.
Collapse
Affiliation(s)
- Ingo Theuerkauf
- Department of Pathology, University of Bonn, Sigmund-Freud-Str. 25, 533127 Bonn, Germany.
| | | | | | | | | |
Collapse
|
14
|
Lopez-Beltran A, Luque RJ, Quintero A, Requena MJ, Montironi R. Hepatoid adenocarcinoma of the urinary bladder. Virchows Arch 2003; 442:381-7. [PMID: 12715173 DOI: 10.1007/s00428-003-0772-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2002] [Accepted: 01/14/2003] [Indexed: 11/26/2022]
Abstract
Hepatoid adenocarcinoma is rare in the urinary bladder with only three well-illustrated previously reported cases. Pathological diagnosis is based on a combination of histological features resembling hepatocellular carcinoma and the positive immunostaining for alpha-fetoprotein. We present the clinicopathological features of four additional cases. The patients were males 66, 85, 61 and 68 years old. Hematuria was the initial symptom in all four patients. Two cases were treated by cystoprostatectomy and the remaining two by transurethral resection of the bladder. On histology, the cases showed a mixture of cells growing in a solid fashion and sheets or anastomosing trabeculae of hepatoid cells merging focally with a secondary glandular pattern of adenocarcinoma. Intracytoplasmic hyaline globules in all and bile production in three of the cases also supported the impression of hepatocytic differentiation. Immunoreactivity for alpha-fetoprotein, low molecular weight cytokeratin, alpha-1-antitrypsin, albumin, epithelial membrane antigen and a striking canalicular pattern when stained against polyclonal carcinoembryonic antigen (CEA), all indicate hepatocellular differentiation. The hepatic nature of the cells was further assessed by detecting the recently incorporated marker hepatocyte paraffin 1, by means of immunohistochemistry and albumin gene mRNA non-isotopic in situ hybridization, both of which had positive signals in all four cases. Three patients died 12, 14 and 19 months after diagnosis. The fourth patient was alive with disease at 26 months of follow-up. In conclusion, hepatoid adenocarcinoma seems to be an aggressive malignant neoplasm that is rare in the bladder whose correct diagnosis may need appropriate immunohistochemical and in situ hybridization means in addition to a complete patient clinical and pathological evaluation. The exact histogenesis and classification of these tumors remains to be established.
Collapse
Affiliation(s)
- A Lopez-Beltran
- Department of Pathology, Cordoba University Medical School and Reina Sofia University Hospital, Facultad de Medicina, Avda. Menendez Pidal S/N, Spain.
| | | | | | | | | |
Collapse
|
15
|
Devouassoux-Shisheboran M, Schammel DP, Tavassoli FA. Ovarian hepatoid yolk sac tumours: morphological, immunohistochemical and ultrastructural features. Histopathology 1999; 34:462-9. [PMID: 10231422 DOI: 10.1046/j.1365-2559.1999.00650.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIM The clinicopathological, immunohistochemical and ultrastructural features of two ovarian hepatoid yolk sac tumours (H-YST) from our files are reviewed. METHODS AND RESULTS Using avidin-biotin-peroxidase complex technique, the immunoprofile of these tumours was compared to that of a classic yolk sac tumour and to that previously reported for hepatocellular carcinomas. The clinicopathological and morphological features of our cases are similar to the seven previously reported ovarian cases. This rare germ cell tumour occurs in young females (mean age = 17.6 years) and presents most commonly with abdominal pain and a large ovarian mass (average size = 140 mm). Histologically, the tumours display a striking resemblance to hepatocellular carcinoma. The absence of an associated typical pattern of yolk sac tumour or other germ cell neoplasm may make it difficult to recognize the germ cell origin of this lesion. Our cases demonstrated positive staining for alpha-fetoprotein and alpha-1-antitrypsin. In addition, there was immunoreactivity with polyclonal carcinoembryonic antigen (CEA) antiserum in a canalicular pattern, focal staining for inhibin, oestrogen and progesterone receptors and absence of immunoreactivity for CK7 that contrasts with the immunophenotype of a usual yolk sac tumour. CONCLUSIONS Ovarian H-YST and hepatocellular carcinoma share a similar immunoprofile. Ovarian H-YST is a highly aggressive tumour, most patients exhibit recurrence or die of disease within 2 years of diagnosis.
Collapse
Affiliation(s)
- M Devouassoux-Shisheboran
- Department of Gynecological and Breast Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000, USA
| | | | | |
Collapse
|
16
|
|
17
|
Roberts CC, Colby TV, Batts KP. Carcinoma of the stomach with hepatocyte differentiation (hepatoid adenocarcinoma). Mayo Clin Proc 1997; 72:1154-60. [PMID: 9413299 DOI: 10.4065/72.12.1154] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A case of hepatoid adenocarcinoma of the stomach is reported, and the literature is reviewed. The stomach is one of the most common sites in which hepatoid adenocarcinomas have been detected. Of the 59 cases reviewed from the literature (including the current case), a 2:1 male predominance was noted, and the serum alpha-fetoprotein level was almost always increased. All patients were adults, and most had evidence of metastases at the time of resection. Prognosis seems less favorable than that associated with the more common intestinal type of adenocarcinoma of the stomach. Hepatoid adenocarcinomas typically show periodic acid-Schiff-positive, diastase-resistant intracytoplasmic globules, which are demonstrated to be positive with antibodies to alpha-fetoprotein. The tumor cells resemble liver cells, and rare cases, including our own, have evidence of bile production. In our case, messenger RNA for albumin, unique to liver cells, was demonstrated by in situ hybridization of the tumor cells.
Collapse
Affiliation(s)
- C C Roberts
- Department of Radiology, University of Arizona Health Sciences Center, Tucson, USA
| | | | | |
Collapse
|
18
|
Arnould L, Drouot F, Fargeot P, Bernard A, Foucher P, Collin F, Petrella T. Hepatoid adenocarcinoma of the lung: report of a case of an unusual alpha-fetoprotein-producing lung tumor. Am J Surg Pathol 1997; 21:1113-8. [PMID: 9298890 DOI: 10.1097/00000478-199709000-00018] [Citation(s) in RCA: 70] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We report on a rare tumor of the lung characterized by its morphologic hepatoid features and alpha-fetoprotein production. This unusual neoplasm arose in the left lung of a 36-year-old man in whom clinical and radiologic examinations did not reveal any other tumor. The serum level of alpha-fetoprotein was measured at 6,090 ng/mL and was parallel to the evolution of the tumor. Despite treatment, the patient died 7 months after the diagnosis. The microscopic appearance of the tumor was the same as observed in hepatocarcinoma and hepatoid adenocarcinoma of the ovary or the stomach, with a tubular, papillary, or trabecular pattern. Periodic acid-Schiff-positive hyaline globules were numerous, and tumor cells showed immunohistologic positivity for alpha-fetoprotein and carcinoembryonic antigen. This lung adenocarcinoma was first described by Ishikura et al. in 1990 and was named hepatoid lung adenocarcinoma. Like the rare hepatoid carcinoma of the gallbladder, the pancreas, the ampulla of Vater, the renal pelvis, and the bladder, the exact histogenesis and the prognosis of this type of lung tumor are not yet known.
Collapse
Affiliation(s)
- L Arnould
- Department of Pathology, University Hospital, Dijon, France
| | | | | | | | | | | | | |
Collapse
|