Difference between revisions of "Liver neoplasms"
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*May be intrahepatic, i.e. ''intrahepatic cholangiocarcinoma'' (abbreviated ''ICC''), or extrahepatic. | *May be intrahepatic, i.e. ''intrahepatic cholangiocarcinoma'' (abbreviated ''ICC''), or extrahepatic. | ||
===Epidemiology=== | ====Epidemiology==== | ||
*Rare - approximately 1/5 the incidence of HCC.<ref>{{Ref GLP|608}}</ref> | *Rare - approximately 1/5 the incidence of HCC.<ref>{{Ref GLP|608}}</ref> | ||
*More common among asians. | *More common among asians. | ||
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Notes: | Notes: | ||
*Biliary stents lead to reactive changes,<ref name=pmid3877438>{{Cite journal | last1 = Carrasco | first1 = CH | last2 = Wallace | first2 = S | last3 = Charnsangavej | first3 = C | last4 = Richli | first4 = W | last5 = Wright | first5 = KC | last6 = Fanning | first6 = T | last7 = Gianturco | first7 = C | title = Expandable biliary endoprosthesis: an experimental study. | journal = AJR Am J Roentgenol | volume = 145 | issue = 6 | pages = 1279-81 | month = Dec | year = 1985 | doi = | PMID = 3877438 }}</ref> these can be confused for malignancy. One must always check whether a biliary stent was in situ at time of biopsy.<ref>STC. 2 October 2009.</ref> | *Biliary stents lead to reactive changes,<ref name=pmid3877438>{{Cite journal | last1 = Carrasco | first1 = CH | last2 = Wallace | first2 = S | last3 = Charnsangavej | first3 = C | last4 = Richli | first4 = W | last5 = Wright | first5 = KC | last6 = Fanning | first6 = T | last7 = Gianturco | first7 = C | title = Expandable biliary endoprosthesis: an experimental study. | journal = AJR Am J Roentgenol | volume = 145 | issue = 6 | pages = 1279-81 | month = Dec | year = 1985 | doi = | PMID = 3877438 }}</ref> these can be confused for malignancy. One must always check whether a biliary stent was in situ at time of biopsy.<ref>STC. 2 October 2009.</ref> | ||
*Usually abundant desmoplasia, ergo hard to get good, i.e. diagnositic, endoluminal brushing specimens.<ref>STC. 6 December 2010.</ref> | |||
===IHC=== | ====IHC==== | ||
Classic IHC pattern:<ref>{{Ref GLP|609}}</ref> | Classic IHC pattern:<ref>{{Ref GLP|609}}</ref> | ||
*CK7 +ve. | *CK7 +ve. | ||
*CK20 +/-. | *CK20 +/-. | ||
*HepPar-1 -ve. | *HepPar-1 -ve. | ||
*AFP -ve.<ref>STC. 6 December 2010.</ref> | |||
ICC vs. HCC:<ref name=pmid19173916>[Evaluation of immunohistochemical markers for differential diagnosis of hepatocellular carcinoma from intrahepatic cholangiocarcinoma] Dong H, Cong WL, Zhu ZZ, Wang B, Xian ZH, Yu H. Zhonghua Zhong Liu Za Zhi. 2008 Sep;30(9):702-5. Chinese. PMID 19173916.</ref> | ICC vs. HCC:<ref name=pmid19173916>[Evaluation of immunohistochemical markers for differential diagnosis of hepatocellular carcinoma from intrahepatic cholangiocarcinoma] Dong H, Cong WL, Zhu ZZ, Wang B, Xian ZH, Yu H. Zhonghua Zhong Liu Za Zhi. 2008 Sep;30(9):702-5. Chinese. PMID 19173916.</ref> | ||